Olatunji F. Aina

Alcohol and substance use portrayals in Nigerian video tapes: an analysis of 479 films and implications for public drug education.

There is an observed increasing trend of substance use among the adolescents and young adults. One of the important aetiologies is “modeling” especially from popular artists portraying their use to the viewing public over the electronic media. Indigenous films on video tapes acted in English or “Yoruba” (a popular Nigerian language) were randomly selected from various retail outlets in Lagos for viewing. The settings were the Ikorodu and Ipaja suburbs of Lagos. The viewing audience in each center was made up of a researcher and two adolescent secondary school students. They were to make notes on each film with scenes of substance use, type, and nature of use. A total of 479 video tapes were studied over a 6 month period, of which 268 (55.9%) contained scenes portraying the use of one or more substances. Two hundred forty-seven (51.6%, N = 479) depicted the use of only one type of substance and the rest, 21 (4.3%, N = 479), portrayed the use of multiple substances. The commonest substance portrayed to be used was alcohol, 197 (41.1%, N = 479), followed by tobacco, 81 (16.9%, N = 479). Cannabis was shown to be used in only 3 (0.6%, N = 479); Cocaine and Heroin in 8 (1.6%, N = 479) of the films. There was no statistically significant difference on substance use portrayal between the home movies acted in English and Yoruba (χ2 = 32.8; df = 7 at p < 0.05). A significant number of films on video tapes in Nigeria portrayed substance use which could act as triggers or reinforcement for substance use among the viewing audience, especially adolescents and young adults. The need to censor video tapes on substance use portrayal was advocated.

Comparative study of depression in hospitalized and stable heart failure patients in an urban Nigerian teaching hospital

OBJECTIVE There are conflicting reports about the presence of depression in Black patients with heart failure (HF). We therefore evaluated the pattern of depression among hospitalized and stable HF patients in a homogenous Black population. METHOD Patients hospitalized for new or decompensated HF were assessed. The Zung Self-Rating Depression Scale (SDS) questionnaire was administered to the subjects who were subsequently interviewed by a psychiatrist using the Hamilton Depression Rating Scale (HDRS). Stable HF patients at the outpatient clinic were used as controls. RESULTS There were 123 hospitalized and 82 stable outpatients. Depression was present in 67% of hospitalized patients and 30.50% of the outpatients (P<.0001, using the SDS indexed scores). Stratifying the SDS indexed scores showed that 45.50%, 19.60% and 1.80% of the hospitalized patients compared with 26.80%, 3.70% and 0% of the outpatients had mild, moderate and severe depression (P=.007 and P=.001), respectively. The HDRS assessment showed that 63.40% of the hospitalized patients and 28.0% of the stable outpatients had significant depression (P<.0001). CONCLUSION Depression affects two thirds of hospitalized urban Nigerian HF patients compared to one third of stable outpatients with HF. The prevalence of depression is similar to the prevalence among European and North American samples.

Screening for depression with Centre for Epidemiological Studies Depression Scale Revised and its implication for consultation-liaison psychiatry practice among cancer subjects: a perspective from a developing country.

Co‐morbidity of depressive symptomatology is a common indication for use of mental health services in oncology. In this regard, screening instruments are useful for prompt identification of mental disorders in cancer. This study is set to evaluate the diagnostic validity of Centre for Epidemiological Studies Depression Scale Revised (CES‐DR) for depression screening in cancer.

A Controlled Study of Depression among Attendees of an Oncology Clinic in West Africa

Objective: Depression is commonly encountered among cancer patients and has been linked with grave consequences if not promptly treated. This study was set to determine the prevalence of depression in cancer patients. Method: The samples were recruited using systematic random sampling and made up of 200 cancer patients and 200 age and sex matched controls that consented and met the inclusion criteria. The instruments used included: Socio-demographic and clinical profile questionnaire, Centre for Epidemiological Studies Depression Scale Revised (CES-DR), and the Schedule for Clinical Assessment in Neuropsychiatry (SCAN). The instruments were administered by the researchers on the subjects and controls, and data obtained were analyzed using SPSS-15. Results: A larger proportion of cancer patients compared to controls had depressive symptomatology (CES-DR score of 16 and above) made up of 98 (49.0%) cancer patients compared to 40 (20.0%) controls, and the difference was statistically significant, p = < 0.001. Seventy-four (18.5%) subjects from the two groups had depressive disorder using SCAN. The prevalence of depression in cancer subjects was 27.5% with 9.5% in controls and the difference was statistically significant with p = < 0.001. A substantial proportion of cancer patients with depression, 36 (65.5%, n = 55), had moderate depression, 15 (27.3%, n = 55) were mildly depressed, and 7.2% (n = 55) had severe depression. Conclusion: A significant proportion of cancer patients had depression compared with the controls with acute medical conditions. Prompt identification and treatment of cancer, mental disorders like depression should be integrated into cancer care in this part of the world.

Mothers' Knowledge of Sickle-Cell Anaemia in Nigeria:

The study ascertains knowledge of mothers of sufferers of sickle-cell anaemia specifically regarding aetiology of the disorder and acceptable medical care. One hundred fifty-seven mothers of children suffering from sickle-cell anaemia (HbSS) attending a haematology clinic of a general hospital in Lagos were randomly sampled and asked about the aetiology and their understanding of the rules of care using a short open-ended questionnaire. The mean age of the mothers was 37.4 and a significant majority belong to the lower socio-economic strata. Thirty-four percent reported having been informed of the hereditary basis of anaemia but 48.4% received no explanation. Doctors, nurses, and lay literature were the main sources of information on the condition, as well as its medical care. The considerable gaps in appropriate knowledge on sickle-cell anaemia in Nigeria observed indicates that adequate and properly-presented information to parents or guardians of patients should be an essential part of a comprehensive care plan.

A Study of Insomnia among Psychiatric Out-Patients in Lagos Nigeria

Insomnia is closely related to psychiatric disorders, occurring as an accompanying symptom or as an aetiological factor. It is also a common side-effect of some of the drugs used in treating psychiatric disorders. Several studies have been carried out in different populations however there is the need for more studies aimed at taking a closer look at this relationship in the Nigerian population. The objective of this work is to study the relationship between insomnia and patient characteristics such as sleeping conditions and psychiatric diagnoses. The study was carried out at the Lagos University Teaching Hospital. The methodology involved administering a socio-demographic questionnaire and the Sleep-50 questionnaire to consenting subjects whose psychiatric diagnoses were ascertained using the Structured Clinical Interview for DSM-IV. An analysis of the one hundred and eighty four subjects studied showed that schizophrenia was the commonest psychiatric diagnosis (35.9%). The prevalence of insomnia in this population was found to be 20.1% and it was significantly most prevalent among those with major depression. The noise experienced at night, the subject’s subjective estimation of hours asleep, being elderly and being unemployed were significantly related to the presence of insomnia. In conclusion the study supports the importance of enquiring about insomnia among psychiatric out-patients and highlights the usefulness of sleep questionnaires in obtaining information in sleep disorder research.

Self-esteem and Suicidal Risk among Subjects with Dermatological Disorders in a West African Teaching Hospital

DOI: http://dx.doi.org/10.5915/41-2-4456 Introduction : Skin diseases are reportedly associated with low self-esteem and can result in anxiety, depression, and suicide. The paucity of research in this important field in Nigeria necessitated this study. Method : A prospective and cross-sectional study on attendees in the dermatology clinic of Lagos University Teaching Hospital, Lagos, Nigeria, with skin diseases ≥6 months duration. An equal number of apparently healthy controls matched for age and sex also were evaluated. The subjects and controls were assessed with the sociodemographic questionnaire Index of Self-Esteem (ISE) and the subscales C, D, E, and J of the Symptom Distress Checklist-90 Revised (SCL-90-R). The data obtained was analyzed using SPSS version 10 on PC. Results: An equal number (80) of subjects and controls, of even sex distribution with mean ages of 33±12.1 and 34.6±7.3 years, respectively, were studied. The common skin diseases among the subjects included acne, urticaria, vitiligo, tinea, and Hansen’s disease. The mean ISE scores of the subjects and controls were 28.7±13.4 and 21.56±10.7, respectively, and the difference was significant with “t” of 3.75*. Assessment with the SCL-subscales showed the subjects’ mean scores ranged from 4.7±5.4 to 11.1±10.6, and the controls’ mean scores ranged from 2.0±3.2 to 5.1±5.2. The differences were significant with “t” ranging from 2.75* to 4.59* (critical “t” =1.66 and p≤0.05). Conclusion: The subjects had statistically significant higher mean scores on assessment compared with the controls. These higher scores indicate lower self-esteem and increased risk of depression and suicide.

Autism spectrum disorder in a community-based sample with neurodevelopmental problems in Lagos, Nigeria

Autism Spectrum Disorder (ASD) is a globally prevalent neurodevelopmental disorder for which early diagnosis and intervention is the mainstay of management. In the African continent, limited data is available regarding the non-clinic based samples. Lack of information available to caregivers and inadequate skilled manpower often limit early detection and access to the few available though under resourced services in the community. Community based screening can be an important drive to create awareness and improve information dissemination regarding services available for those living with this disorder. This is a descriptive cross-sectional study utilizing data obtained from participants of a community-based autism screening exercise. The surveillance exercise was part of the annual Orange Ribbon initiative for autism awareness and screening held in 2014. Data was obtained from 85 participants involved in the Autism Surveillance screening exercise within the Lagos community. Community public service radio announcements state wide and word of mouth were used to invite and enroll eligible participants to the screening and consultation exercise. A second stage screening and a brief sociodemographic questionnaire followed by a third stage clinical interview and evaluation using the Diagnostic and Statistical Manual of Mental Disorders - 5 Edition (DSM 5) were used. Appropriate consultation and referrals to services in the community were given. Participants had a mean age of 7.53 years (SD 4.35). Twenty-nine (34.5%) met the diagnosis of ASD. Other diagnosis included attention deficit hyperactivity disorder (ADHD), language and speech disorder, intellectual disability (8.3%) and learning disorders (9.5%). Main health concerns to caregivers were poor language development in all (100%), of which 11 (40.7%) were non-verbal; gaze avoidance was seen in 14 (48.3%) and challenging behavior in 12 (42.9%). Comorbidities included seizure disorders (3.4%) and ADHD (6.9%). Persons with autism had history of ASD behavior more often when compared to the other neurodevelopmental disorders and these findings were statistically significant. Referrals were given to caregivers to engage in services within the community. As seen in this study, community understanding of ASD is poor in such locations, in which many persons with other neurodevelopmental disorders are often presented as having autism. Caregivers in the study location are distressed by many symptoms associated with autism and their comorbid conditions. Currently there is an evident role for frequent large scale community based screening and autism awareness exercises possibly using inter-sectoral collaboration as a strategy.

Disordered eating attitudes: demographic and clinico-anthropometric correlates among a sample of Nigerian students

OBJECTIVES We set out in this study to determine the demographic and clinico-anthropometric correlates of disordered eating attitudes among undergraduate students of two higher institutions in Lagos, Nigeria. METHODS This cross-sectional descriptive study was conducted among 1,054 participants after written informed consent. A socio-demographic questionnaire, the Eating Attitude Test (EAT-26) and 12-item General Health Questionnaire (GHQ-12) were administered to the participants. In addition, their blood pressure, height and weight were measured, and body mass index (BMI) was calculated. RESULTS The study participants comprised of 561(55.6%) males with median age of 21.4 years. The mean (±SD) score on EAT-26 was 11.52(±8.54), and 16% of all the respondents were categorized as having disordered eating attitude. A significant relationship was found between disordered eating attitude and age (p= 0.027), gender (p= <0.001), institution of study (p= 0.005), systolic blood pressure (p=0.019), BMI (p= 0.027) and psychological distress (p=0.005). CONCLUSION Our study observed disordered eating attitude to be prevalent among young adults, and demographic along with clinico-anthropometric factors constituted associated factors. Our findings strengthen the basis to incorporate health awareness programs aimed at improving nutrition and eating behavior among the young adult population. Future research is needed.

Quality of life and associated factors among poststroke clinic attendees at a University Teaching Hospital in Nigeria

Background: Quality of life (QOL) measures are effective in quantifying disease burden after stroke, more so than levels of debility. The objective of this study is to determine QOL and associated factors of stroke survivors in Lagos, Nigeria. Materials and Methods: Seventy stroke survivors (study sample) and seventy stable hypertensive patients (control sample) attending clinics at a Nigerian hospital were recruited for the study. Respondents were assessed using sociodemographic/clinical questionnaires, modified mini-mental state examination, modified Rankin Scale, schedule for clinical assessment in neuropsychiatry, and World Health Organization-QOL-BREF. Results: Mean ages of the study and control respondents were 57.43 (±9.67) years and 57.33 (±9.33) years, respectively. Each sample comprised 38 male and 32 female respondents. Stroke survivors were significantly more likely to: be unemployed (P= 0.001), pay more for healthcare (P = 0.001), consume alcohol (P = 0.02), and have physical impairments (P = 0.001) compared with control. The mean QOL scores of stroke survivors were significantly lower than controls across all spheres. Stroke survivors who were unemployed, younger, female, paying more for healthcare, more disabled, with right stroke lateralization, having comorbidities, and sexual dysfunction had significantly poorer QOL specific grades. Depression or anxiety poststroke was also associated with reduced QOL means scores. Conclusion: Besides, clinical variables such as levels of disability and stroke lesion lateralization, other factors such as unemployment, health costs, age, gender, and emotional problems influenced QOL after stroke.