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Travel medicine physicians without basic knowledge of psychiatry are often poorly prepared to anticipate the likelihood of decompensation of mental illness in this cohort of travellers. We propose travel psychiatry as an emerging area of both research and clinical interest. This article draws on the sparse available literature and over 40 years of combined clinical experience in psychiatry B.
Mental health challenges of international travel Travel, even with a recreational motivation, is inherently stressful and the perceived stressful impact is likely a product of the travel itinerary, destination, activities and individual traveller susceptibility. Travellers who are deemed medically fit to travel and who have no history of mental disorder may develop acute de novo psychosis during their trip.
Drug tourism, whereby tourists cross international borders for the purpose of obtaining or using psychoactive substances, is associated with significant adverse health effects, including drug-induced psychosis, unintentional physical injury, risky sexual behaviour and criminal acts. The sense of uncontrollability and inherent unpredictability presented by travel may cause travellers to develop anxiety symptoms or worsen an existing anxiety disorder.
Culture shock is a travel phenomenon that exposes travellers to the risk of anxiety symptoms, in addition to confusion, a sense of isolation, rejection and deprivation due to cultural differences experienced while abroad. Patients may feel overwhelmed when immersed in an unfamiliar destination and struggle to make the necessary adaptations to acclimatise to local customs and cultural norms.
Moreover, travelling abroad inevitably leads to a lack of daily structural routine, separation from social supports in some cases and a lack of support, which can precipitate poor adherence to prescribed psychotropic medications. Furthermore, there is evidence that jet lag can exert a debilitating effect on travellers with mental illness, with sleep loss being demonstrated to increase the risk of episodes of hypo mania in individuals diagnosed with bipolar disorder.
Where an individual develops an acute episode of mental illness, receiving appropriate intervention in a timely fashion can be challenging for a number of reasons, including problems communicating health difficulties to clinicians, cultural differences, poorly established diagnoses and lack of clarity in relation to the psychiatric history of the traveller.
Furthermore, difficulties may arise if there is delay in the diagnosis of physical illness, such as hypoglycaemia, epileptic aura or hypothyroidism, which may initially present with alterations in mental health. Repatriation to the home country where patients can receive specialised treatment from their multidisciplinary mental health team in a familiar environment may be the most appropriate intervention.
Although it is reasonable to postulate that leisure activities abroad may be beneficial for people with mental illness, research is lacking in this area. One qualitative study from The Netherlands explored how engaging in travel contributes positively to the mental rehabilitation of psychiatric patients. Many positive experiences were reported, including maintenance of social contact; the opportunity to develop foreign language skills; enrichment of life resulting from enjoyment and cherishable memories; positive influence on self-esteem; and a departure from the monotonies of daily routine life.
We have recently reported similar positive findings from semi-structured interviews conducted with a series of patients with chronic psychotic illnesses who engaged in travel independently, on their own or with friends. There are currently travel restrictions within South Africa.
What are the travel restrictions in Pretoria? Do I have to wear a face mask on public transport in Pretoria? Wearing a face mask on public transport in Pretoria is mandatory. Is it compulsory to practice social distancing in Pretoria? The social distance requirement in Pretoria is 2 metres.
This information is compiled from official sources. To the best of our knowledge, it is correct as of the last update. Visit Rome2rio travel advice for general help. The most affordable way to get from Nieu-Bethesda to Pretoria is to drive and car train, which costs R - R and takes 16h 10m. More details What is the fastest way to get from Nieu-Bethesda to Pretoria? The quickest way to get from Nieu-Bethesda to Pretoria is to taxi and bus and fly which costs R 2 - R 5 and takes 7h 43m.
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