At the onset of the COVID-19 pandemic in early 2020 in South Africa, many safety measures were implemented to protect the lives of the population. Ironically, these same safety measures have negatively impacted on the lives of children and their caregivers resulting in increased mental health problems. This study forms part of the multicountry Co-SPACE (COVID-19: Supporting Parents, Adolescents and Children during Epidemics) study that explores how families are coping during the COVID-19 pandemic, and what caregivers can do to help support their children’s mental health. This paper aims to gain a better understanding of the mental health status of families specifically in South Africa in the early onset of the pandemic during restrictive lockdown measures, and identify certain risk factors that might contribute towards deteriorating mental health. Two hundred and fifty-four South African parents and carers of children and adolescents completed an online survey about their child’s mental health as well as their own mental health during and post- hard lockdown in South Africa. Data collection took place over the period of the first and second waves of the COVID-19 pandemic in South Africa. Results showed that children experienced significantly higher mental health problems than adolescents (p = 0.016). Younger children were particularly negatively affected by lockdown and had more mental health problems than adolescents (p = 0.023); including emotional problems (p = 0.017), misconduct (p = 0.030), and hyperactivity (p = 0.001). Additionally, the presence of special educational needs/neurodevelopmental disorders (SEN/ND) was associated with more mental health problems (p = 0.001). Surprisingly, single parent households, which is another well-known risk factor showed no differences in mental health problems compared to nuclear families. There was also a reciprocal relationship between parental/carer mental health and child/adolescent mental health, with higher level of endorsement of mental health problems in children by parents/caregivers who themselves associated with higher levels of depression, anxiety and stress (all p’s < 0.001). These results highlight the dramatic impact that COVID-19 had on children, adolescents and parents in South Africa early in the pandemic, and emphasises the need for specific support structures to be implemented within the SEN/ND community, as well as for younger children and single parent households.

Childhood onset schizophrenia (COS) is diagnosed before the age of 13 years, and early onset schizophrenia (EOS) is diagnosed before the age of 18 years. EOS is considered extremely rare and its prevalence in comparison to the worldwide prevalence of schizophrenia (1%) has not adequately been studied. Patients who experience the first episode of psychosis need to be treated early and optimally to lessen the morbidity and improve the outcome of the illness. Treatment needs to be a combination of both pharmacological and non-pharmacological modalities. Pharmacological intervention is necessary for remission, improvement of positive symptoms and to aid with the efficacy of psychosocial interventions. There is a lack of efficacy and safety data of the use of antipsychotic medication in children, with most of the information available being extrapolations of adult data. An increased use of atypical antipsychotic drugs in the treatment of EOS has been accompanied by growing concern about the appropriate use and...

Objective: Iron deficiency may play a role in the pathophysiology of attention deficit hyperactivity disorder (ADHD) by causing dopamine dysfunction, but there is conflicting evidence in the litera...

Infant mental health is strongly connected to an infant’s relationship with a responsive, warm, and available caregiver. However, maternal mental illness reduces a mother’s ability to detect and respond to changes in her infant’s expressions and communication, which may have important consequences for infant attachment and emotion regulation. The Shared Pleasure (SP) paradigm in parent–infant interactions is defined as ‘the parent and the child sharing positive affect in synchrony’ and is considered to be a possible screening marker for early identification of at-risk dyads. A paucity of data exists for the application of SP as a measurable paradigm in developing countries. This study aimed to evaluate the SP paradigm using women attending a tertiary psychiatric maternal mental health clinic in Cape Town, South Africa. A sample of mothers (N = 78) and young infants (2–6 months old) were assessed for SP moments using video recordings of the dyad in free play. SP moments occurred in only 20.5% of the sample. SP moments were more frequent in younger babies (under 3 months of age). There were significantly more SP moments in dyads where mothers had no mental illnesses (p = 0.021) or were married (p = 0.016). Black African mothers also experienced significantly more SP moments with their babies (p = 0.033) than their Caucasian or Mixed-ancestry counterparts. This study explored the application of the ‘SP paradigm’ on women with and without mental illness who attended a maternal mental health clinic. Tracking SP moments in a larger sample of culturally diverse, at-risk and, mentally-ill population of mothers and their infants offers the possibility of a simple language- and culture-free measure to identify at-risk dyads.