Olawale Ogunsemi

Stigmatising attitude of medical students towards a psychiatry label

BackgroundThe aim of this study is to evaluate the effect of a psychiatric label attached to an apparently normal person on the attitude of final year medical students at a Nigerian university.MethodsA questionnaire with sections on demographic information, a single-paragraph case description illustrating a normal person, a social distance scale and questions on expected burden was used to elicit responses from 144 final year medical students who have had previous exposure to psychiatric posting. The students consisted of two randomly assigned groups; group A received a case description with a psychiatric label attached while group B received the same case description but without a psychiatric label.ResultsA total of 68 (47.2%) of the students responded to the questionnaire with the attached psychiatric label, while 76 (52.8%) responded to the questionnaire without the attached label. There was no statistical difference in age (p = 0.187) and sex (p = 0.933) between the two groups of students. The students who responded to the questionnaire with the attached psychiatric label would not rent out their houses (p = 0.003), were unwilling to have as their next-door neighbour (p = 0.004), or allow their sister to get married (p = 0.000) to the man depicted in the case description compared with those that responded to the questionnaire without label. This group also felt that the man would exhaust them both physically (p = 0.005) and emotionally (p = 0.021) in any relationship with him.ConclusionThese results strengthen the view that stigma attached to mental illness is not limited to the general public; medical students are also part of the stigmatising world. There is, therefore, a need to incorporate issues concerning stigma and its reduction as a core component of the mental health curriculum of medical schools.

Community based diabetes risk assessment in Ogun state, Nigeria (World Diabetes Foundation project 08-321).

Objective: The study assessed the risk of developing type 2 diabetes Mellitus in Ogun State, Nigeria. Materials and Methods: Finnish Medical Association diabetes risk score was administered across 25 communities facilitated by non-communicable disease clinics established under a World Diabetes Foundation project. Subjects in the high risk group had blood glucose estimated. Results: 58,567 respondents included 34,990 (59.6%) females and 23,667 (40.3%) males. Majority (61.2%) were between 25 years and 54 years. Considering waist circumference, 34,990 (38.1%) females and 23,667 (5.3%) males had values above 88 cm and 102 cm respectively. Overall, 11,266 (19.2%) were obese and 28.9% overweight using body mass index (BMI). More females had elevated BMI than males. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of all subjects were 129.54 mm Hg ± 23.5 mm Hg and 76.21 mm Hg ± 15.5 mm Hg respectively. Prevalence of hypertension (Joint National Committee VII classification) was 27.7%. More subjects had normal DBP than SBP (68.2% vs. 42.5% P < 0.05). Mean fasting blood glucose (FBG) of all subjects was 5.5 mmol/L ± 0.67 mmol/L. Using a casual blood glucose >11.1 mmol/L and/or FBG >7 mmol/L, the total yield of subjects adjudged as having diabetes was 2,956 (5.05%). Mean total risk score was 5.60 ± 3.90; this was significantly higher in females (6.34 ± 4.16 vs. 4.24 ± 3.71, P < 0.05). A total of 2,956 (5.05%) had high risk of developing DM within 10 years. Conclusion: The risk of developing DM is high in the community studied with females having a higher risk score. There is urgent need to implement diabetes prevention strategies.

Quality of sleep among hypertensive patients in a semi-urban Nigerian community: a prospective study.

Abstract Background: Sleep complaints are common in patients with chronic medical disorders; however, the prevalence of “poor sleep” in patients with chronic hypertension is not yet known in Nigeria. In the general population, insomnia negatively impacts quality of life. Objective: The objective of this study was to examine the quality of sleep among Nigerian hypertensive patients. The study aimed to measure the prevalence of “poor sleep” in hypertensive patients and to examine the association between quality of sleep and the severity of hypertension in this population. Methods: Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) in chronic hypertensive patients attending a tertiary hospital in Nigeria. This was compared with normal control subjects. Results: The mean age of the hypertensive patients was 58.15 ± 9.65 years (range, 19–76 years). This did not differ from the controls at 58.7 ± 10.8 years. A total of 80 (60.6%) respondents were females with a mean age of 58.3 ± 12.2 years while 52 (39.4%) were males with a mean age of 58.8 ± 11.7 years. The mean body mass index (BMI) was 26.42 ± 4.13 kg/m2 (range, 18.9–36.4 kg/m2), with 63.1% of the respondents being either overweight or obese. The mean systolic blood pressure was 167.4 ± 21.8 mm Hg (range, 100–210 mm Hg) while the mean diastolic blood pressure was 96.7 ± 14.9 mm Hg (range, 60–130 mm Hg). Fifty-six (42.4%) hypertensive subjects were “poor sleepers” (global PSQI > 5), with a global mean PSQI of 5.03 ± 3.28. This was significantly more than 17.3% of control subjects, with a mean global PSQI of 3.10 ± 0.83. Among the hypertensives, there was no statistically significant relationship between the global PSQI and the age (P = 0.653), sex (P = 0.710), BMI (P = 0.253), systolic (P = 0.145), and diastolic blood pressure (P = 0.827). Conclusions: Poor sleep is common in hypertensive patients and may be associated with lower health-related quality of life. Large-scale, prospective, longitudinal studies on quality of sleep in hypertensive patients are needed to confirm the high prevalence of impaired quality of sleep in this population and to examine the association between severity of hypertension and quality of sleep while controlling for potential confounding variables. We hypothesize that severity of hypertension directly influences quality of sleep, and poor quality of sleep may worsen hypertensive conditions.

Detection of mental disorders with the Patient Health Questionnaire in primary care settings in Nigeria

Mental disorders lead to difficulties in social, occupational and marital relations. Failure to detect mental disorder denies patients potentially effective treatment. This study aimed to assess the prevalence and nature of mental disorders at the primary care settings and the recognition of these disorders by the attending physicians. Over a period of eight weeks, consecutive and consenting patients who attended three randomly selected primary health care facilities in Sagamu Local Government Area of Ogun state were recruited and administered a questionnaire that included a socio-demographic section and Patient Health Questionnaire (PHQ). A total of 412 subjects took part in the study. Subject age ranged from 18–90 years with a mean age of 52.50±21.08 years. One hundred and seventy-six (42.7%) of the subjects were males. A total of 120 (29.1%) of the subjects had depressive disorder, 100 (24.3%) had anxiety disorder, 196 (47.6%) somatoform disorder and 104 (25.2%) met the criteria for an alcohol related problem. The PHC physicians were only able to diagnose disorders relating to mental health in 52 (12.6%) of the subjects. Health and work situations accounted for more than three-quarters of the causes of stress experienced by the subjects. We conclude that there is a high prevalence of mental disorders among patients seen in primary care settings and that a significant proportion of them are not recognized by the primary care physicians. Stress relating to health, work and financial problems is common among primary health care attendees. Physicians in primary health care should be alert to the possibility and the impact of undetected psychiatric morbidity.

Socio-Demographic Characteristics, Partner Characteristics, Socioeconomic Variables, and Intimate Partner Violence in Women with Schizophrenia in South-South Nigeria

Intimate partner violence (IPV) is common among patients with severe mental illness such as schizophrenia. Few surveys have explored IPV among this specific group of patients and the demographic characteristics of victims in Nigeria. The aim of this survey was to explore socio-demographic, socioeconomic characteristics of victims and partners. A cross-sectional randomized survey of 79 women with schizophrenia from a major adult psychiatric outpatient in South-south Nigeria was done. The Structured Clinical Interview for DSM-IV (SCID) was used to establish the diagnosis of schizophrenia among the participants and a purposely designed questionnaire to assess IPV. The mean age of the participants was 38.3 ± 2.8 years; the majority (73%) reported at least one form of IPV. Verbal abuse was the most (71%) prevalent form of IPV. Our findings highlight a need for proper attention to demographics of both victims and their male partners by clinicians.

Prevalence and associated risk factors of Kola nut chewing among secondary school students in Osogbo, Nigeria

The objectives of this study were to determine the prevalence and pattern of Kola nut use among secondary school students in Osogbo, Osun State, Nigeria. The study also aimed to determine the association of socio-demographic variables (of the students and their parents) with kola nut chewing. A questionnaire consisting of socio-demographic variables, the stimulant use section of the WHO Students Drug Use Questionnaire was administered on three hundred and eighty-five (385) randomly selected students of the two Local Government Areas of Osogbo. The prevalence rate of kola nut use was calculated and some socio demographic variables were determined. The 30-day prevalence rate of kola nut use was 11.2%. The one-year prevalence of kola nut use was 29.1 percent and the lifetime rate was 74.8 percent. Majority of users started at age 14 years or below. Kola nut use was associated with lower age group, poor school attendance, polygamous background, low education of mother, high education of father and the description of mother as being too permissive. The findings suggest the need to increase the awareness of the dangers of kolanut use among adolescents. Control program are urgently needed to prevent student wastage.

Perception of service satisfaction and quality of life of patients living with schizophrenia in Lagos, Nigeria

Objective: To assess service-satisfaction and quality of life among patients with schizophrenia in a tertiary psychiatric healthcare facility in Lagos, Nigeria. Methods: Cross-sectional survey of 101 (out of 120) patients diagnosed with schizophrenia attending the outpatient clinic of the Federal Neuro-Psychiatric Hospital Yaba, Lagos, Nigeria. The Structured Clinical Interview for DSM-IV diagnosis (SCID), Charleston Psychiatric Out-patient Scale (CPOSS), and the World-Health Organisation Quality of Life –Bref scale (WHOQOL-BREF) was used in assessing diagnosis, patient satisfaction and subjective quality of life respectively. Results: The ages of the patient ranged from 19-81. Males (49.5%) and females (50.5%) had almost equal distribution. Mean duration of attendance was 8.7years ± 8.50. Service satisfaction ranged between 25-60 on the CPOSS. Areas that had higher mean scores on CPOSS were with items (1) Helpfulness of the records clerk (3.70±1.1), (7) Helpfulness of services received (3.69±1.0). Subjective quality of life was high (3.65±1.8), satisfaction with health was also high (3.40±1.1). Service satisfaction correlated with Quality of life at P < 0.00.

Psychological morbidity among ophthalmic patients in south west Nigeria

Background : Eye disorders extol great impact on the quality of life and mental health of individuals, thus constitute a public health concern. This study aimed to evaluate the prevalence and sociodemographic characteristics of psychological problems among patients with eye disorders in a major eye clinic in southwest Nigeria. Materials and Methods : It was a cross-sectional survey. Consecutive patients attending the clinic over a period of 6 weeks were administered questionnaire with sections on demographic and clinical characteristics, General Health Questionnaire and Hospital Anxiety and Depression Scale to assess psychological morbidity, anxiety, and depressive disorders. Results : One hundred and forty-seven respondents consisting of 51.7% female took part in the study. Glaucoma (28.6%) was the most frequent diagnosis. About a fifth (19.7%) of the respondents had psychological morbidity, while 15 and 14.3% of the respondents screened positive for anxiety disorder and depression respectively. More than half of the respondents (54.4%) had poor visual acuity. There was no statistical difference between the respondents who were visually impaired compared with those that were not as far as psychological morbidity (P = 0.93), anxiety (P = 0.99), and depression (P = 0.22) are concern. Respondents with comorbid conditions were significantly more likely to have psychological morbidity (P = 0.05) and anxiety disorders (P = 0.02) compared with those without comorbidity. Conclusion : There is high prevalence of psychological disorders among ophthalmic patients with or without visual impairment. Thus, assessment for psychological distress and other emotional disorders such as anxiety and depression among patients presenting with eye disorders is very important.

Self-esteem and social acceptance of the adolescent substance user among high school students in Lagos, Nigeria

ABSTRACT Introduction: Much research have focused on self–esteem and substance use among adolescents. Little is known about the relationship between self esteem and social acceptance of colleagues who are known as substance users. The study explored this relationship among high school students in Lagos, Nigeria. Methods: A cross-sectional survey was done using structured questionnaires and case description scenarios among 221 high school students in several public senior secondary schools in Lagos, Nigeria. Results: Study revealed that majority of the participants were more willing to socially accept and be intimate with colleagues who take alcohol in almost all the case scenarios. Colleagues who abused marijuana and cocaine were more socially acceptable to majority of the participants in many case scenarios than those who abused nicotine. Choice of association with colleagues who abused substances was not related to self-esteem. Conclusion: Social acceptance of substance users among adolescents may be influenced by the perception of socially desirable qualities and not necessarily the substance use. Social associations with substance users may be limited to the school environment. Social acceptance of substance user was related to self esteem evaluation of participants.

Social distancing attitudes toward the mentally ill and victims of sexual violence among college students in Southwest Nigeria

Background and Objectives: Negative perception and distancing attitudes toward individuals with mental illness and victims of sexual violence are prevalent in many societies and cultures, Attitudes toward these two groups of individuals in sub-Saharan Africa remains negative in the larger society. However, not much survey has been done among college students who represent an educated youthful generation that can usually be targets for positive reorientation programs. The aim of the study was to compare social distancing attitudes using hypothesized social situations involving individuals with mental illness and victims of sexual violence. Methods: A cross-sectional random survey was carried out in two federally-funded institutions in Lagos Mainland, Nigeria. Results: One hundred and seventy-two students responded. Negative social distancing attitudes were expressed toward both groups by college students. Negative perception and distancing are high among college students toward both groups with higher negativity toward individuals with mental illness (10.10±0.7) than with sexual violence (9.16±1.25). Conclusion: There is a need to focus on enlightenment programs on mental illness and sexual violence among college students in higher institutions.