Femi O. Fatoye

Sociodemographic and obstetric risk factors for postpartum depressive symptoms in Nigerian women.

Objective: Studies from the Western culture have emphasized psychosocial risk factors for the development of postnatal depression (PND). In Africa, poor obstetrics practice and sociodemographic factors may contribute significantly to the risk of PND. The goal of this study was to examine sociodemographic and obstetric risk factors for postnatal depressive symptoms in a Nigerian community. Methods: 876 women recruited at 6 weeks postpartum from the postnatal and infant immunization clinics of 5 participating health centers were screened with the Edinburgh Postnatal Depression Scale (EPDS). Sociodemographic and obstetric information were also obtained through a structured questionnaire. Results: The mean EPDS score was 5.66 (SD = 4.20). Depression was diagnosed in 128 (14.6 %) of the postpartum women. The predictors of PND include hospital admissions during the pregnancy (OR 3.95, CI 2.57-6.07), female sex of the baby (OR 2.74, CI 1.87-4.03), preterm delivery (OR 4.21, CI 2.78-6.39), instrumental delivery (OR 3.32, CI 1.79-6.16), Cesarean section (OR 3.58, CI 1.72-7.48), and being single (OR 3.44, CI 2.15-5.53). Conclusion: Although the prevalence of PND symptoms seems to be the same across cultures, risk factors differ significantly. This study identified certain sociodemographic and obstetric risk factors for postnatal depressive symptoms in an underdeveloped community. These factors must be taken into consideration when planning intervention and preventive strategies for these women.

Emotional distress and its correlates among Nigerian women in late pregnancy

A cross-sectional study was carried out in a Teaching Hospital to compare women in late pregnancy and matched controls for emotional distress. Each of the 156 pregnant women was matched with a control and studied to determine the relationship of some obstetric and sociodemographic factors with anxiety and depression. All the subjects were evaluated using the state form of the State-Trait Anxiety Inventory (STAI-state) and the Zungs Self-Rating Depression Scale (SDS), which are standardised instruments for assessing depression and anxiety, respectively. The pregnant women had significantly higher levels of anxiety and higher levels of depression than their non-pregnant controls. Four of the factors evaluated (age, level of education, socio-economic status and parity) were not found to be significantly related to anxiety or depression among the pregnant women. However, four other factors, i.e. polygamy, previous abortions, mode of previous delivery (caesarean section and instrumentally-assisted delivery) and previous puerperal complications had positive and significant associations with anxiety and depression. The implications of these findings are discussed.

Attitude towards antipsychotics among out-patients with schizophrenia in Nigeria

Objective:  The study aim to assess the attitude of patients with schizophrenia attending out‐patient clinics in Nigeria towards antipsychotic medication and examine the factors associated with such attitude.

Quality of Life and Associated Factors among Adults with Epilepsy in Nigeria

Objective: Epilepsy is a common condition worldwide and has been observed to affect quality of life (QOL). Though, much has been written on this subject among western populations, little research has been done in developing countries of Africa including Nigeria. The study aims to identify factors associated with quality of life among adult epilepsy patients in this environment. Method: Respondents were evaluated using the 10-item Quality of Life in Epilepsy Inventory (QOLIE-10), the 30-item General Health Questionnaire (GHQ-30), the modified Mini Mental State Examination (mMMSE), and the Hospital Anxiety and Depression Scale (HADS). Diagnosis of epilepsy was based on clinical and electroencephalographic findings. Results: The mean age of the 51 respondents was 27.7years (SD = 9.7). Thirteen (25.5%) had an average of 2 seizure episodes in the month preceding the interview, while 37 (72.5%) have had the condition for more than 5 years. Factors that were significantly associated with overall quality of life included being female (p < 0.05), seizure frequency (p < 0.01), using more than 1 anti-epileptic drugs (AEDs) (p < 0.01), GHQ-30 score (p < 0.01), high anxiety score (p < 0.001), and high depression score (p < 0.01). Multiple regression analysis showed that depressive symptoms were the single most important factor explaining low QOL. Other factors were GHQ-30 score, seizure frequency, and being a woman. Conclusion: Controlling seizures and paying attention to the psychological needs of adult epileptics will have a positive effect on the QOL among Nigerian epileptics.

Interictal anxiety and depression symptoms in Nigerians with epilepsy: A controlled study

The goals of this study were to compare symptoms of anxiety and depression between patients with epilepsy and a healthy control group, and to determine the possible factors associated with clinically significant anxiety and depression symptoms in patients with epilepsy. One hundred and four adult Nigerians (52 with epilepsy and 52 matched healthy controls) were assessed with the Hospital Anxiety and Depression Scale (HADS). The results obtained indicated a statistically significant difference in anxiety and depression symptoms between patients with epilepsy and controls. The association between anxiety symptoms and polytherapy was significant (P=0.008), as was the association between depression symptoms and duration of epilepsy longer than 10 years (P=0.04). Emotional problems are more common in patients with epilepsy than in the general population. Identifying and monitoring those with epilepsy of long duration and rational prescription of antiepileptic drugs are important in reducing the risk of affective problems.

Depressive Symptoms in a Sample of Women Following Perinatal Loss

OBJECTIVE The aim of the study is to identify variables associated with depressive symptoms among women shortly after perinatal loss. METHOD Respondents who agreed to participate in the study were interviewed, and sociodemographic data were obtained from them. The Hospital Anxiety and Depression Scale and the Edinburgh Postnatal Depression Scale (EDPS) were thereafter administered on each respondent. RESULTS Respondents with perinatal loss had high rate of depressive symptoms (52% on EDPS), the rate was significantly higher, when compared with the control group (chi2 = 10.16, P=0.001). Factors significantly associated with depressive symptoms included previous perinatal losses, poor support from husband and occurrence of antenatal complications. CONCLUSION Depressive reaction following perinatal loss is very common. Programs need to be designed to help these women cope with their loss and to reduce subsequent psychological morbidity.

Pattern of depression among patients in a Nigerian family practice population

Abstract Background: This study determines the pattern of depression among patients attending the Family Practice Clinic at Wesley Guild Hospital, Ilesa, Nigeria. Socio-demographic and clinical correlates associated with depression were identified. Methods: Two hundred and fifty (250) newly registered patients who attended the clinic between June and September 2005 were selected by the systematic random sampling method and studied. Relevant data were collected using a pre-tested interviewer-administered questionnaire that incorporated Zungs Depression Scale. Results: The age of the study subjects ranged from 16 to 84 years, with a mean age of 49.66 + 14.95 years. One hundred and forty-nine of the 250 subjects (59.6%) were found to have one form of depression or the other. Of these, one hundred and seven (42.8%) had mild depression, forty (16.0%) had moderate depression and only two (0.8%) had severe depression. Depression was found to be commoner in the age groups from 45 years and above, and there was a significant association between age and depression. There were 74 males and 176 females in the sample population, showing a male to female ratio of 1:2.4. Out of 149 depressed subjects, one hundred and four females (69.8%) had depression, while depression was present in 45 males (30.2%). Forty-seven (87.0%) of 54 subjects with no formal education had depression, while depression was found in 102 (52.0%) of the 196 educated subjects. Low educational status was significantly associated with depression in this study. Only two (0.8%) of the 250 subjects gave a positive family history of psychiatric illness, and these two subjects had mild to moderate depression. The proportion of depressed subjects who lived below the poverty level was significantly greater than that of non-depressed subjects. Substance use was also significantly more common among depressed subjects than the non-depressed group. Conclusion: The proportion of patients with depressive symptoms in family practice clinics is high, and it is highly correlated with socio-demographic factors and low socioeconomic status. Family physicians are hereby enjoined to pay greater attention to patients with these factors, as they are at increased risk of depression. In order to reduce the high proportion of depressive symptoms and its adverse impacts on patients seen in family practice clinics and in the community as a whole, there is a need for effective implementation of poverty-alleviation programmes and universal basic education.

Cognitive impairment and quality of life among stroke survivors in Nigeria.

The study investigated cognitive impairment and quality of life (QOL) among 109 consecutive stroke survivors and 109 normal controls. Each group comprised 64 (58.7%) men and 45 (41.3%) women. The modified Mini Mental State Examination (mMMSE) and the WHO Quality of Life Questionnaire (WHOQOL-Bréf) indicated that 19 (17.4%) stroke survivors had cognitive deficits (mMMSE score < 16) compared with 5 (4.6%) control participants (χ12 = 4.27, p<.05). Control participants performed significantly better on orientation, language comprehension, laterality, and the WHOQOL-Bréf. Being GHQ-30 positive predicted poor performance on the mMMSE among the stroke survivors and reduced QOL on three of the four domains of the WHOQOL-Bréf. In addition, previous psychiatric illness, paresis, low education, and shorter time elapsed after a stroke predicted reduced QOL on one or more domains of the WHOQOL-Bréf but age and sex of the stroke survivors were not associated with quality of life, and not with cognitive function.

Depressive symptoms and associated factors following cerebrovascular accident among Nigerians

Background: Much has been written on post stroke depression in the last 10 years in developed countries. However little is known about this important condition in this environment, thus the need for this study. Aims: This study intends to estimate the prevalence of post stroke depression (PSD) and identify other associated factors. Methods: One hundred and eighteen stroke survivors, managed at a Nigerian Teaching Hospital (mean post stroke survival duration = 11 months) were compared with 118 hypertensive controls using Beck Depression Inventory (BDI) and the modified Mini Mental State Examination (mMMSE). Sociodemographic variables were controlled for. Results: Sixteen (13.6%) control subjects compared with 47 representing 38.8% had significant depressive symptoms. Cognitive deficit, paresis and low education were identified as predictors of depressive symptoms (PSD) among survivors. Conclusion: Physicians need to be alert to this condition, especially since it can be treated and this will improve the quality of life among this group of patients.

Psychological reactions to amputation in a sample of Nigerian amputees

OBJECTIVE The study compares psychological symptoms between amputees and other orthopedic patients. METHOD Forty-two consecutive amputees were interviewed between 7 and 28 days after amputation, and an equal number of other orthopedic patients matched for age, sex, marital status, and occupation were used as controls. Each respondent completed a sociodemographic questionnaire, while clinical variables were obtained from the case notes. Respondents also completed the General Health Questionnaire, State Trait Anxiety Inventory, and the Zung Self-Rating Depression Inventory. RESULTS The mean age of amputees in this study was 42.33 years (S.D.=15.89 years), and the average weekly income is #3500.00 (