Biomedical subjects
Publications and source records attributed to T Buchan.
A case of Capgras syndrome in a black Zimbabwean patient is described. The syndrome occurs in the setting of a schizophrenic illness, but psychodynamic factors are readily identified despite the patient's different cultural background.
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In spite of the comparative rarity of anorexia nervosa in African patients, the case of a young black Zimbabwean woman which fulfils Feighner's diagnostic criteria is presented. Special reference is made to several unusual features which include the social and psychological conflicts engendered by changes of culture, the clinical symptoms, and the role of a traditional healer in her recovery. A speculative hypothesis concerning aetiology is suggested.
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Forty-one patients admitted to hospital over a 5-year period because of charges arising from their having caused a violent death were studied. Data pertaining to the victim, the weapon used and the locality are analysed. The diagnostic categories for the patients are set out and the course and outcome are followed. Implications for future management are discussed, with particular reference to relevant social and cultural factors.
Forty Black men diagnosed as schizophrenic and admitted to Ingutsheni Hospital during a period of 3 months, were allocated alternately to treatment with either clothiapine or chlorpromazine. Six patients were excluded from the trial because of an incorrect diagnosis and 34, 17 in each group, completed the trial. The 2 groups were comparable for both severity and symptoms of their illnesses. Degrees of regression of psychotic symptoms as assessed by the Brief Psychiatric Rating Scale, were comparable for the 2 groups. Adverse effects were not troublesome with clothiapine and there was no evidence of disturbed liver function, but haemoglobin values and white cell counts were sometimes decreased. EEG studies showed that clothiapine produced an increase in the slow activity but no paroxysmal acitvity. It was concluded that clothiapine is a valuable drug for the management of actue schizophrenia.
In view of impending new legislation in Rhodesia, a survey of 256 criminal mental patients admitted to Ingutsheni Hospital was undertaken. These patients were all treated by the author and were admitted during the 5-year period 1 January 1970-31 December 1974. Among these patients there were 113 schizophrenics (44%) and 57 epileptics (22%); these proportions are not significantly different from those previously found among civil patients. The outcome was that 86 patients (33, 6%) were discharged to stand trial, 107 (41, 8%) were discharged in terms of a recommendation by the Mental Hospital Board and 57 (22, 3%) were returned to prison. Recommendations are made for the provision of a new forensic psychiatric unit, and some of its functions are discussed.
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