Olatunji A. Abiodun

Psychosocial correlates of alcohol, tobacco and cannabis use: findings from a Nigerian university.

The possible correlates of alcohol, tobacco and cannabis use were investigated in a survey conducted among undergraduate students of the University of Ilorin, Nigeria. Factors that emerged as common correlates to the three substances investigated were peer influence, self-reported poor mental health, religiousity, parental/guardian supervision, perceived availability and perceived harmfulness. In addition, drinking and smoking were found to be commoner among the male sex and among respondents who reported study difficulty. There was also a significant positive relationship between cannabis use and a polygamous family background and belonging to an older age group. Although the data used in the analysis is limited due to its cross-sectional nature, the observations made are useful enough for the formulation of primary prevention strategies. A further and more elaborate longitudinal study is, however, suggested.

Psychiatric morbidity in a pregnant population in Nigeria

Psychiatric morbidity among 240 pregnant women attending an antenatal unit was assessed by a two-stage screening procedure, using the General Health Questionnaire (GHQ-30) and Present State Examination Schedule (PSE). The prevalence of psychiatric morbidity was found to be significantly associated with younger age (< 24 years), being primigravid, married for less than 1 year, having an unsupportive husband, and a previous history of induced abortion. It is suggested that more attention needs to be paid to the mental health of pregnant women in developing countries (where pregnancy rates and the risks associated with pregnancy/delivery are much higher than in the developed countries) at the primary, secondary, and tertiary levels of health care.

Alcohol-related problems in primary care patients in Nigeria

Abiodun OA. Alcohol‐related problems in primary care patients in Nigeria.

Physical morbidity in a psychiatric population in Nigeria

The rate of physical morbidity amongst 191 psychiatric in-patients in a Nigerian general hospital was found to be 27.2%. Older psychiatric patients were observed to be significantly more likely to suffer from physical morbidity. Infective processes constituted 57.7% of the physical health problems identified in the study population. Organ systems most frequently involved were the central nervous system (mainly as acute organic brain syndrome from septicaemia) (28.9%), cardiovascular/haematological (19.2%), and gastrointestinal (17.3%). Over 70% of physical disorders remained undiagnosed by the referring sources. It is emphasized that adequate attention should be paid to the physical status of psychiatric patients (both new and old cases) at all levels of health care. Collaborative work between medicine and psychiatry should also be encouraged in developing countries, and this should extend beyond clinical services and training (undergraduate and postgraduate) into the areas of evaluative research.

Mortality in a psychiatric population: A Nigerian psychiatric hospital experience

ABSTRACT— Out of a total of 10,661 patients admitted over a 10‐year period in a Nigerian psychiatric hospital, 138 deaths were recorded. A decreasing trend in the mortality figures was demonstrated despite a marked increase in the number of admissions. There were more male deaths (60%) than female deaths (40%). The majority of the patients who died (64%) were under the age of 40 years. Infection was the single most important cause of death. There was one case of suicide and one other death resulted from ECT. Sudden unexplained deaths occurred in 19% of the cases. Possible ways of further reducing the mortality figures are suggested.

Psychiatric disorders in children attending a Nigerian primary care unit: functional impairment and risk factors

BackgroundThere is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians.MethodsA cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ) to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7) and 30% of low scorers (score < 7). Diagnosis of psychiatric disorders was based on DSM-IV criteria.In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment) while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity.ResultsIt was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p < 0.001). Following logistic regression, younger age of children, frequent hospital attendance and maternal parenting distress independently predicted psychiatric morbidity while child psychopathology and maternal parenting distress predicted functional impairment.ConclusionsChild psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of difficult cases to the child and adolescent psychiatric unit of the hospital.

A comparison of two screening instruments in detecting psychiatric morbidity in a Nigerian pediatric primary care service: assessing clinical suitability and applicability.

BACKGROUND To improve poor attendance and underutilization of the child and adolescent psychiatric service in the University of Ilorin Teaching Hospital, Ilorin, Nigeria, we compared a child behavior questionnaire (CBQ) with reporting questionnaire for children (RQC) for use in our primary care unit where the bulk of referrals come from to determine which is more applicable. METHODS This was a cross-sectional two-stage study on the prevalence and pattern of psychiatric disorders in children attending the primary care unit of University of Ilorin Teaching Hospital, over a 6-month period. CBQ and RQC were completed by the mothers of 350 children aged 7-14 years in the first stage; in the second, a stratified subsample of 157 children based on scores on CBQ were interviewed using the childrens version of the schedule for affective disorders and schizophrenia (Kiddie-SADS-PL). The receiver operating characteristics (ROC) analysis was carried out to determine the screening properties of CBQ and RQC. RESULTS The optimal cutoff score for CBQ and RQC were 7 and 1, respectively. Sensitivity, specificity, and misclassification rates at the cutoff for CBQ was 0.8 (80%); 0 96 (96%); 0.083 (8.3%), and RQC was 0.90 (90%); 0.78 (78%); 0.19 (19%). The discriminating ability of CBQ indicated by the area under the curve (AUC) in the ROC was 0.93 while RQC was 0.88. CONCLUSION Even with the evident marginal superior discriminating ability of CBQ in our study in primary care, RQC has the advantage of brevity and ease of application for workers at this level. In the child and adolescent clinic CBQ may still be preferred.

An investigation of the patterns and outcomes of Electroencephalographic (EEG) recording requests in the management of neuropsychiatric disorders in a teaching Hospital in Nigeria

Objective To evaluate the relevance of Electroencephalography (EEG) in the management of various neuropsychiatric conditions in University of Ilorin Teaching Hospital (UITH), Ilorin. Background EEG is still relevant in the diagnosis and management of patients with seizure disorders and extends to other neuropsychiatric conditions. However, very few studies have examined the use of EEG in developing countries, including Nigeria. Methods The EEG records of 154 patients between January 2012 and December 2012 were reviewed. EEG units records, including EEG request forms and EEG reports were examined. Socio demographic data, clinical data and the neurologists comments on the EEG recordings were extracted and recorded on the proforma form. Results A total of 142(92.2%) of the patients out of 154 had complete records and were studied. Majority (84.5%) of the patients were below the age of 30 years. Various types of seizure disorders accounted for 80% of the provisional diagnosis. The EEG diagnosis based on the interpretation of the EEG records showed that 96 (67.6%) of the patients had normal records. Conclusion EEG still plays a very important role in the investigation of neuropsychiatric conditions especially epilepsy in developing countries. EEG facilities should be readily available.

Prevalence and clinical implications of psychopathology in adults with epilepsy seen in an outpatient clinic in Nigeria

BACKGROUND The psychopathological and clinical characteristics of adult patients with epilepsy attending our neurology clinic were evaluated to determine prevalence of psychopathology and its associated factors towards improving services and initiating collaborative care which is currently nonexistent. METHODS The study was a two-stage procedure conducted over 1 year using the General Health Questionnaire in the first stage and Schedule for Clinical Assessment in Neuropsychiatry in the second stage. Diagnosis of psychiatric disorders was based on International Classification of Diseases: 10th Revision criteria. RESULTS Sixty-three patients were interviewed. Mean age was 34.43 ± 13.7 years; more than half of the patients had less than one seizure episode per month. Fourteen patients (22.2%) had partial epilepsy; 40 (63.5%), generalized; and 9 (14.3%), unclassified seizures. The rate of psychiatric morbidity was found to be 28.6%. Depressive disorders were the most common (66.7%), followed by psychotic disorders (11.1%), anxiety disorders (11.1%) and dementia (11.1%). Psychopathology was more common in women (P=.007), those older than 40 years (P = .038) and those with partial epilepsy (P = .017). CONCLUSION About one third of patients with epilepsy studied had undetected and untreated psychopathology. Our neurology clinic urgently needs currently nonexistent collaborative care involving neurologists, psychiatrists and primary care physicians in order to improve the mental health of the patients with epilepsy.