Boladale M. Mapayi

Anxiety disorders among Nigerian women in late pregnancy: a controlled study

SummaryThis study aimed to investigate the rate and type of anxiety disorders among Nigerian women in late pregnancy. Women in late pregnancy (n = 172) and a non-pregnant control group were assessed for DSM-IV anxiety disorders. The rate of any anxiety disorder in the pregnant women was 39.0% compared with 16.3% in the non-pregnant population (p < 0.001). Although all the anxiety disorders were more common, only the rate of social anxiety disorder was significantly higher among the pregnant than non-pregnant population. Correlates of anxiety disorder in the pregnant population include age less than 25 years (OR 4.62, 95% CI 2.39–8.92), primiparity (OR 3.90, 95% CI 2.00–7.59) and presence of medical conditions (OR 3.60, 95% CI 1.28–10.12). More research is needed in this field to ascertain the specific association between pregnancy and anxiety disorders.

Caregiver burden in families of patients with depression attending Obafemi Awolowo University teaching hospitals complex Ile-Ife Nigeria

OBJECTIVE The objective of this study was to assess caregiver burden among relatives of patients on treatment for depressive disorder attending the psychiatry outpatient clinic of the Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Nigeria. METHODS A cross sectional design was used. Hundred caregivers of patients with ICD-10 diagnosis of depression, on outpatient treatment for at least six months were recruited from the psychiatric outpatient clinic. Caregivers completed a semi-structured socio-demographic questionnaire, the Zarit Burden Interview and General Health Questionnaire (GHQ) 12. Descriptive statistics were used to describe socio-demographic variables; association between dependent and independent variables were assessed using Pearsons correlation, chi squared and t test as appropriate. RESULTS The mean ZBI score was 41.32 (S.D. = 9.82), 45% of respondents reported moderate to severe burden, spouses constituted 57% of caregivers. Age at onset of depression (t = 2.46, P = .02) number of hospitalization,(χ(2) = 9.82, P = 0.001), and current active symptoms (χ(2) = 36.1, P = .001) were all significantly associated with burden score. Severity of symptoms (r = 0.48, P < .01) and age at onset of illness (r = -0.26, P < .01) both correlated significantly with burden scores, while GHQ score among caregivers also correlated significantly with burden scores (r = 0.52, P < .01). CONCLUSIONS Caregivers of depressed patients experience moderate to severe burden. Caring for the depressed need to change from a patient focused approach to a combined patient and caregiver approach.

Exploration of the Psychometric Properties and Correlates of the 10 item Connor-Davidson Resilience Scale among Family Caregivers of Nigerian Patients with Psychiatric Disorder

Background: Despite studies in developed countries repeatedly reporting on the positive influence of resilience on the ability of family caregivers to withstand the burden of providing care for their relatives no literature is currently available regarding the construct and the factors associated with resilience among the family caregivers of Nigerian psychiatric patients. Methods: This is a cross-sectional descriptive study in which 234 family caregiver-patient dyads were consecutively recruited over a period of 6 months from the psychiatric outpatients’ clinics of two university teaching hospitals in South-western Nigeria. The caregivers completed the 10 item Connor-Davidson Resilience Scale (CDRISC-10) in addition to other measures. Exploratory factor analysis was used to evaluate the dimensionality of the scale. The scale’s reliability and validity were also examined. Results: Exploratory Factor Analysis revealed a uni-dimensional model of the 10 item CD-RISC among the family caregivers. Internal consistency of the scale’s items was modestly satisfactory (Cronbach’s alpha 0.87). The evidence for the convergent validity of scale was provided by statistically significant correlations with the family caregivers’ scores on the Zarit Burden Interview (r =0.276, p<0.001), MINI Suicidality module (r=0.312, p<0.001), General Health Questionnaire-12 (r =0.220, p<0.001) and Patient Health Questionnaire-9 (r=0.282, p<0.001). Hierarchical linear regression analyses showed that, the main variance in the family caregivers’ score on the CDRISC-10 was accounted for by the MINI Suicidality module. Conclusions: The scale has exhibited satisfactory psychometric qualities as a tool for the assessment of resilience among the family caregivers of Nigerian patients with psychiatric disorders in terms of its reliability and validity. Our study further affirms that the construct of resilience measured with the 10 item CDRISC is best explained by a one dimensional factor.

Trust in Physician Scale: Factor structure, reliability, validity and correlates of trust in a sample of Nigerian psychiatric outpatients

BACKGROUND Trust is essential in the patient-physician relationship and has not been explored among Nigerian psychiatric outpatients. OBJECTIVES The purpose of this study was to evaluate the psychometric characteristics of the Trust in Physician Scale among a cross-sectional sample of stable Nigerian outpatients receiving treatment for psychiatric disorders. METHODS A consecutive sample of outpatients attending a Nigerian university teaching hospital psychiatric clinic in South-western Nigeria completed the scale (N=223). Factorial analysis, internal consistency, validity and correlates of the scale were evaluated. RESULTS The structure of the Trust in Physician Scale was best explained by a 2 factor construct. Cronbachs alpha was 0.68, indicating a rather modest degree of internal consistency. The 2 factors extracted also had modest internal consistencies (Cronbachs alpha 0.66 and 0.76). A fair degree of construct validity was indicated by weak positive correlation of trust with medication adherence and the numbers of previous admissions. The mean trust score was relatively high. Significant positive correlations were observed between trust scores and adherence score, number of previous admissions and the number of schizophrenic relapses. CONCLUSION The results suggest that despite the comparatively weak psychometric properties of the Trust in Physician Scale, it is still useful in the evaluation of trust among Nigerian psychiatric outpatients. More studies are needed to further explore and compare the properties of this scale across a wider range of patient groups in Nigeria, and to identify other factors that could interact with trust among the different patient populations in our environment.

Depression and Associated Factors Among Gay and Heterosexual Male University Students in Nigeria

Homosexuality is a recognized risk factor for depression in high-income countries; however, there is little research investigating the relationship between depression and sexual orientation in developing countries, especially in Africa. In this first study to investigate psychopathology in sexual minority men in Nigeria, the prevalence rates of depression in Nigerian gay and heterosexual individuals were compared as well as the explanatory power of risk and resilience factors in both groups. Eighty-one gay and 81 heterosexual male university students were, respectively, recruited from the Obafemi Awolowo University. Both groups were assessed for depression and other clinical factors, including alcohol and other substance use, suicidal ideation, and resilience. Gay students were further assessed for sexuality-related variables, including minority stress factors such as internalized homophobia and perceived stigma. The prevalence rates of depression among gay and heterosexual students were, respectively, 16 and 4.9% (OR 3.7; 95% CI 1.15–11.82), and this increased likelihood for depression was significantly attenuated by resilience. Clinical factors correlated significantly with depression in both groups, explaining 31% of the variance in depression in gay and heterosexual students, respectively. Sexuality-related variables including internalized homophobia and perceived stigma were further associated with depression in gay students—accounting for a further 14% of the variance of depression in gay students. The findings highlight the importance of minority stress factors in understanding depression among non-heterosexual individuals in a developing country, and the need for further research to investigate the mechanisms of these relationships in such settings.