MHM Magazine

INTRODUCTION In a world where we often seek comfort in nature, herbal remedies are becoming increasingly attractive. This trend likely reflects a broader interest in alternative and complementary medicine, with attempts to find a balance between traditional and modern approaches to healthcare. In recent years, there has been growing interest in the potential of Sceletium tortuosum as a remedy for mental health issues. WHAT IS SCELETIUM TORTUOSUM ? Sceletium tortuosum , better known as “kanna”, “channa” or “kougoed” (roughly translated as “things to chew on”) is a succulent plant native to South Africa. Traditionally, Sceletium tortuosum has been chewed, snuffed, and smoked, but it can also be ingested in the form of tea. The indigenous Khoikhoi and San communities have used this plant for its mood-enhancing and stress-relieving properties. More recently, these properties have drawn attention in psychiatric research as studies demonstrated Sceletium tortuosum ’s potential effectiveness in treating mental health issues such as anxiety, depression, substance use disorder, and bulimia nervosa. It has previously also been noted that Sceletium tortuosum may be of benefit in the treatment of obsessive-compulsive disorder (OCD) given its apparent ability to inhibit serotonin reuptake. Not much attention has been given to the use of Sceletium tortuosum in common OCD-related disorders (OCRDs) such as trichotillomania (TTM, or hair-pulling disorder) and skin-picking disorder (SPD, or excoriation disorder), which also fall under the umbrella of body-focused repetitive behaviour disorders (BFRBDs). The understanding of BFRBDs is still evolving, and there is a lack of well-established, evidence- based treatments for many of these conditions, warranting further research. WHAT ARE BODY-FOCUSED REPETITIVE BEHAVIOUR DISORDERS? As the name suggests, BFRBDs involve self-directed body-focused behaviours such as compulsive nail-biting, cheek-biting, or nose- picking, and repeated unsuccessful attempts to decrease or stop the behaviour. TTM is another BFRBD, characterised by repeated hair- pulling despite efforts to stop, often resulting in significant hair loss or bald patches. SPD is also a BFRBD in which individuals excessively pick at their skin, despite attempts to stop, often leaving scarring and causing infections. Besides medical complications, these conditions have many psychosocial consequences such as feelings of embarrassment and shame after a hair-pulling or skin-picking episode and diminished self-esteem and self-confidence. Both TTM and SPD are associated with avoidance of social situations and difficulties in interpersonal relationships, which can further exacerbate the psychosocial consequences of these disorders. The aetiology is multifactorial, involving genetic factors as well as psychological and emotional components. Anxiety, stress and depression are often comorbid in these conditions and can trigger or exacerbate pulling or picking. The most effective treatment for TTM and SPD appears to be behavioural therapy, i.e., more specifically habit reversal therapy (HRT). N-acetylcysteine (NAC), olanzapine USE OF SCELETIUM TORTUOSUM FOR MENTAL HEALTH PURPOSES Kayleigh Beukes, Clara Marincowitz & Professor Christine Lochner SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University 28 | MENTAL HEALTH MATTERS | 2023 | Issue 6 MHM