Psychiatry in Kenya: yesterday, today and tomorrow.. An overview

Changes over Time in Intracranial Air in Patients with Cerebral Air Embolism: Radiological Study in Two Cases

Cerebral air embolism can be easily identified on computed tomography (CT) scans. However, changes in the distribution and amount of intracranial air are not well known. We report two patients with cerebral air embolism and present imaging findings on the serial changes in the intracranial air. We thought that the embolic source was venous in one patient because CT showed air inflow in cortical veins in the bilateral frontal areas, reflecting air buoyancy. In the other patient, CT showed air inflow into not only the cortical veins but also the bilateral cerebral hemispheres and we thought this to be a paradoxical cerebral air embolism. We found that intracranial air can be promptly absorbed and while cerebral infarcts due to air are clearly visualized on diffusion-weighted images (DWI), the air may rapidly disappear from images. In patients with suspected cerebral air embolism whose CT findings show no intracranial air, DWI should be performed because it may reveal cerebral infarction due to cerebral air embolism.

Depressive disorders in Ethiopia. A standardized assessment using the SADD schedule

Fifty-two depressed patients were selected from out-patients at the psychiatric department of St. Paul's Hospital in Addis Ababa. A clinical assessment on each patient was carried out using a slightly revised SADD schedule. The findings were very similar to those from previous SADD studies in different cultures. The same "core" of depressive symptomatology could be detected in Ethiopian depressed patients. Most patients presented with somatic complaints. An interesting finding was that more women than men admitted aggressive feelings or acts. Remarkably few "culture-specific" data were found, which probably is not surprising when using a diagnostic tool with a cultural bias. Suggestions are put forward to explain the difference in frequency of some symptoms in Ethiopian patients compared with patients from other countries.

Life events occurring before and after onset of depression in a Kenyan setting--any significance?

In a controlled study of life events in depressed patients in Kenya it was found that the rate of life events was higher in the depressed group in the 27 weeks preceding the onset of depression but with a sharp increase in the last 6-9 weeks before onset. It was also found that the depressed patients continued to experience independent life events after the onset of the depression. It is hypothesized that the continued occurrence of life events after the onset of depression is an incentive to seek help and, eventually, a psychiatric referral.

Schizophrenia with depression: causal or coexistent?

Fifty-one schizophrenic patients diagnosed using the New Haven Schizophrenic Index and 29 other patients who did not score enough on this index for a diagnosis of schizophrenia were studied for depressive symptoms using the Present State Examination. There was no significant difference in the frequency of depressive symptoms in the two groups.

Study of delusions in Kenyan schizophrenic patients diagnosed using a set of research diagnostic criteria

Eighty 'psychotic' Kenyan patients of African origin were screened using the New Haven Schizophrenic Index (NHSI). Fifty-one of these (64%) were found positive. Delusions were found to be significantly more common (P less than 0.001) in the NHSI positive group than in the negative group. Sex and age had no effect on the distribution of delusions in general but level of education did. These findings are compared and contrasted with findings of similar investigations and some of their implications are discussed.