Mobolaji Usman Dada

Factors associated with caregiver burden in a child and adolescent psychiatric facility in Lagos, Nigeria: a descriptive cross sectional study

BackgroundDefinitions of burden of care stress the effect of the patients mental illness on the family. There are generally very few studies in this environment on caregiver burden in child/adolescent mental ill-health. This study aimed to identify patient and caregiver characteristics that are associated with caregiver burden.MethodCaregivers of patients attending the Child and Adolescent Clinic of the Neuropsychiatric Hospital, Yaba, Lagos [n = 155] were consecutively recruited over a one-month period. The caregivers were administered a sociodemographic questionnaire, the General Health Questionnaire, Zarit Burden Interview, and the Columbia Impairment Scale. Scoring on the Childrens Global Assessment Scale was done by clinicians.ResultsMost caregivers observed in this study were females (80.5%), with mothers of the patients accounting for 78% of all the caregivers. A higher percentage of the patients were males (52.8%). Moderate to severe/severe burden was recorded among 25.2% of caregivers. Factors associated with caregiver burden were patients level of functioning [r = 0.489, p < 0.001], psychiatric morbidity in the caregiver [r = 0.709, p < 0.001], level of impairment as assessed by the caregiver [r = 0.545, p < 0.001], and childs level of education [t = 3.274, p = 0.001]. Each one independently predicted caregiver burden.ConclusionThe study reveals a high level of burden among the caregivers of children and adolescents with mental health problems.

Prevalence and correlates of psychiatric morbidity among caregivers of children and adolescents with neuropsychiatric disorders in Nigeria.

OBJECTIVE To screen for psychiatric morbidity among caregivers of patients attending a child and adolescent psychiatric clinic. METHOD A total of 155 patients and their caregivers were consecutively recruited over a 1 month period. Sociodemographic and clinical information on patients was obtained either from the hospital records or from the caregiver. Scoring on the Childrens Global Assessment Scale (CGAS) was done by clinicians. The caregivers were administered a sociodemographic questionnaire, GHQ-12, Zarit Burden interview, and the Columbia Impairment Scale. RESULTS Most caregivers observed in this study were females (80.5%) with mothers of the patients accounting for 78% of all the caregivers. A higher percentage of the patients were males (52.8%). Among the caregivers, 39.4% had GHQ Scores of 3 and above. Factors associated with psychiatric morbidity among caregivers include the high level of subjective burden of care, low level of functioning, high degree of impairment and low level of education among patients. CONCLUSION The study reveals a high level of psychiatric morbidity among the carers of children and adolescents with mental health problems.

Dexamethasone induced psychosis presenting with catatonic features

Catatonia is a complex condition characterized by the presence of various motor signs and symptoms. It remains a poorly understood, poorly studied, and poorly recognized syndrome. Catatonic features are seen in a range of psychiatric conditions including psychotic disorders, mood disorders, conversion disorder and dementia. Studies have also identified over 35 medical and neurological illnesses associated with catatonia including corticosteroids exposure, central nervous system (CNS) structural damage, encephalitis and other CNS infections, seizures, metabolic disturbances, phencyclidine exposure, neuroleptic exposure, lupus cerebritis, disulfuram, porphyria, and other conditions. These medical causes of catatonia account for between 20% to 30% of such cases.

Assessment of Depression in a Primary Care Setting in Nigeria using the PHQ-9

Context: Mental disorders are major contributors to the burden of diseases all over the world. In general practice, which provides essentially primary care, depression is the most common mental disorder seen and often goes unrecognized. Aims: The aims of the study were to determine the prevalence of depression, the variables associated with depression, and the degree of recognition by the Physician in family medicine unit. Setting and Design: A cross-sectional descriptive survey of consecutive patients who presented at the general medical out-patient unit of the State University Teaching Hospital, Ado-Ekiti, Nigeria was done. Materials and Methods: Data were collected using a questionnaire incorporating sociodemographic variables and primary diagnosis made by attending Physician. Depression was assessed with the PHQ-9. Results: Two hundred and seventy two patients were interviewed during the period of the study. Participants were mostly of 45 years or older (51.2%), female (59.9%), married (68.4%), and educated (85.7%). One hundred and thirty (47.8%) of the respondents had significant depressive symptoms with majority (49.2%) being classified as mild. Statistical analysis revealed significant association between depression and age, gender, marital status, and clinical diagnoses (P < 0.05). Over a quarter (28.7%) were presented with infectious diseases, other diagnoses made included cardiovascular disorders (15.8%), endocrine disorders (8.8%), psychiatric disorders other than depression (2.9%) and none had depression as primary diagnosis. Conclusions: The prevalence of depression among patients attending the general medical out-patient clinics is high and highly under-recognised.

Alcohol use and psychological wellbeing of health workers in a Nigerian Hospital: An exploratory study

Background The degree of alcohol use influences ones mental health and psychological wellbeing. Psychological well-being of health workers, however, is crucial to the quality of care their patients receive. Aims The aim of this study was to determine the pattern of alcohol use and factors associated with psychological well-being of health care workers at a University Teaching Hospital. Methods This was a cross sectional survey of health workers in the medical and surgical specialties at the State University Teaching Hospital in Nigeria. Socio-demographic questionnaire, the 10-items Alcohol Use Identification Test (AUDIT) and the 12-items General Health Questionnaire (GHQ-12) were used to assess socio-demographic, alcohol use and psychological well-being of the participants. Statistical analyses were done using the Statistical Package for Social Sciences (SPSS) version 16. Appropriate statistical tools were used to determine relationships between various variables. Results A total of 256 participants were interviewed. Fifteen (5.9%) of the respondents were either hazardous or harmful drinkers. Psychological distress was reported among 17.2% of the respondents and this was significantly associated with marital status, years of practice, specialty of practice, presence of ongoing chronic illness, current stressors and level of alcohol use. Conclusion A high proportion of the participants in the study were abstainers and a significant number were experiencing psychological distress. Psychological distress was however found to be significantly associated with harmful alcohol use, some socio-demographic variables, and work related factors. Efforts should be geared towards identifying these factors so as to ensure effectiveness and well-being of health workers.

Perceptions and attitudes of students of mass communication toward mental illness in Nigerian Tertiary Institution

Background: The power of the modern mass media is not limited to its ability to communicate information and entertain but derives primarily from its ability to define situations, thereby enabling it to construct social reality. Stigma is related to negative stereotyping and prejudicial attitudes that in turn lead to discriminatory practices. Aims: The study sought to know the perceptions of and attitudes of mass communication students towards mental illness and the mentally ill. Settings and Design: The study population comprised of final year Diploma students of Mass Communication of a foremost tertiary institution in Nigeria. Methods and Material: The World Psychiatric Association questionnaire measuring attitudes towards Schizophrenia was modified and administered to the students. Results: Study also showed only one-fifth of all respondents had contact with either an advert or a promotion about mental illness. About three-quarter (74.1%) of those who had come in contact with information on mental illness had done so through audiovisuals including television and radio. More than half of the students ranked environmental factors foremost among causes of mental illness. Majority of the students (85.9%) would definitely not marry someone with mental illness. Conclusions: The enormous potential and influence the media has on mental health issues would require that mental health professionals provide great input into the enlightenment program for these young and mental health-naive potential image makers.

Hazardous alcohol use among doctors in a Tertiary Health Center

Background: Doctors have been identified as one of the key agents in the prevention of alcohol-related harm, however, their level of use and attitudes toward alcohol will affect such role. Aim: This study is aimed at describing the pattern of alcohol use and the predictors of hazardous drinking among hospital doctors. Setting: Study was conducted at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Design: A cross-sectional survey involving all the doctors in the teaching hospital. Materials and Methods: All the consenting clinicians completed a sociodemographic questionnaire and alcohol use was measured using the 10-item alcohol use disorder identification test (AUDIT) and psychological well-being was measured by the 12-item General Health Questionnaire (GHQ-12). Statistical Analysis Used: Statistical analyses were done using the Statistical Package for Social Sciences version 16. Chi-square tests with Yates correction were used to describe the relationship between respondent′s characteristics and AUDIT scores as appropriate. Results: There were a total of 122 participants. Eighty-five (69.7%) of them were abstainers, 28 (23%) were moderate drinkers, and 9 (7.3%) hazardous drinkers. With the exception of age, there was no significant relationship between sociodemographic status, years of practice, specialty of practice, and hazardous alcohol use. Experiencing stress or GHQ score above average is significantly associated with hazardous drinking. Conclusion: Hazardous drinking among hospital doctors appears to be essentially a problem of the male gender, especially among those older than 40 years. Stress and other form of psychological distress seem to play a significant role in predicting hazardous drinking among doctors.

Pattern and predictors of alcohol use disorders in a family practice in Nigeria.

Background: Primary care has been identified as a key setting for the reduction of alcohol-related harm, while general practitioners are expected to play a significant role. The study aimed at identifying pattern of, and factors that are associated with alcohol use disorders (AUDs) among patients attending Family Medicine unit of State University Teaching Hospital. Materials and Methods: Sample was selected through a random sampling from a population of patients, aged 18-65 years, attending the general medical out-patients unit of the hospital from January to April 2013. A pretested, semi-structured questionnaire was administered, incorporating sociodemographics and the diagnoses made by the attending Physician. The participants also completed the alcohol use disorders identification test (AUDIT) questionnaire and the patient health questionnaire-9. Results: The prevalence of AUDs among the population of general out-patients was 9.7%. The AUDIT scores of the participants range from 0 to 29 with a mean of 1.3 (standard deviation = 4.08). AUDs were significantly associated with gender, level of education, occupational class, and the presence of significant depressive symptoms (P < 0.05). There was no statistically significant association found for age, employment status, marital status, and religion. Conclusion: The prevalence of AUDs among population studied was lower compared with a similar study in similar setting, but however, significant. AUDs were predicted by gender, lower education level, occupational group, and the presence of significant depressive symptoms mostly in the mild to moderate form. Identifying the group at risk in clinical setting may go a long way in reducing the adverse effect of AUDs in our society.