Olutayo O. Aloba

Anxiety disorders among Nigerian women in late pregnancy: a controlled study

SummaryThis study aimed to investigate the rate and type of anxiety disorders among Nigerian women in late pregnancy. Women in late pregnancy (n = 172) and a non-pregnant control group were assessed for DSM-IV anxiety disorders. The rate of any anxiety disorder in the pregnant women was 39.0% compared with 16.3% in the non-pregnant population (p < 0.001). Although all the anxiety disorders were more common, only the rate of social anxiety disorder was significantly higher among the pregnant than non-pregnant population. Correlates of anxiety disorder in the pregnant population include age less than 25 years (OR 4.62, 95% CI 2.39–8.92), primiparity (OR 3.90, 95% CI 2.00–7.59) and presence of medical conditions (OR 3.60, 95% CI 1.28–10.12). More research is needed in this field to ascertain the specific association between pregnancy and anxiety disorders.

The psychometric characteristics of the 4-item Suicidal Behaviors Questionnaire-Revised (SBQ-R) as a screening tool in a non-clinical sample of Nigerian university students

BACKGROUND Suicide is a major contribution to mortality among university students in developed countries. There is no reliable and validated self-report suicide assessment scale with adequate sensitivity and specificity for the identification of Nigerian university students who are at risk of future suicidal behaviors. OBJECTIVE The objective of this study was to examine the psychometric characteristics of the 4 item Suicidal Behaviors Questionnaire-Revised (SBQ-R) as a screening tool for suicide risk assessment among university undergraduate students in South-western Nigeria. METHOD This is a cross-sectional descriptive study involving 536 undergraduate Nigerian students. The students completed the SBQ-R, in addition to a sociodemographic and academic related questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the 12 item General Health Questionnaire (GHQ-12). Suicidal risk categories among the students were determined by interviewing them with the items of the suicidality module section of the Mini International Neuropsychiatric Interview (MINI). RESULTS Cronbachs alpha for the SBQ-R items was 0.80. Construct validity was supported through significant positive correlations with the HADS-Anxiety and Depression subscales, and the GHQ-12. Receiver Operating Characteristics (ROC) curve evaluation suggests that the best cut-off total score with the optimal sensitivity (0.882), specificity (0.875) and highest accuracy (0.879) was 8 in terms of identifying the students at high risk of suicide (Area Under the Curve=0.928; 95% Confidence Interval=0.890-0.966; Standard Error=0.019). CONCLUSIONS The use of the SBQ-R may be an important and vital step in the prevention of suicidal attempts among Nigerian university students.

The 10-Item Connor-Davidson Resilience Scale: Factorial Structure, Reliability, Validity, and Correlates Among Student Nurses in Southwestern Nigeria.

BACKGROUND: The 10-item Connor–Davidson Resilience Scale (CD-RISC) has demonstrated satisfactory psychometric properties as a measure of resilience in all the previous studies conducted in developed countries. OBJECTIVE: The objective of this study was to explore the psychometric characteristics of the 10-item CD-RISC among students nurses in southwestern Nigeria. DESIGN: This descriptive cross-sectional study involved a total of 449 student nurses who completed the 10-item CD-RISC in addition to measures of self-esteem, depression, religiosity, and psychological distress. RESULTS: The scale demonstrated adequate reliability (Cronbach’s α = .81) and satisfactory validity with significant correlations with the measures of self-esteem, depression, religiosity, and psychological distress. Factor analyses revealed that resilience was best explained by a two-factor construct. CONCLUSIONS: The scale is a valid measure of resilience among Nigerian student nurses.

A review of Quality of Life studies in Nigerian patients with psychiatric disorders.

The concept of Quality of Life is becoming an increasingly important measure of the impact of psychiatric disorders and is now recognized as useful in the healthcare evaluation of patients with psychiatric disorders. The aim of this review was to document and analyze the research data on quality of life in Nigerian patients with psychiatric disorders. The electronic databases, Medline and Pubmed were searched for published articles on quality of life in Nigerian patients with psychiatric disorders. A total of 6 studies met the inclusion criteria. All the studies employed the generic World Health Organization Quality of Life Scale - Brief version, which is the only quality of life instrument whose psychometric properties have been evaluated among Nigerian patients with psychiatric disorders. Some of the studies revealed that quality of life was significantly associated with socio demographic factors such marital and employment status and social support. Poor quality of life was reported to be associated with illness related factors such as co morbid medical problems, presence of anxiety and depressive symptoms and non adherence to medications. All the studies with the exception of two were conducted in centers located in South-western Nigeria. Quality of life in Nigerian patients suffering from psychiatric disorders is under-researched. There is need for more studies to prospectively investigate quality of life and associated factors among Nigerian patients with psychiatric disorders.

Exploration of the Psychometric Properties and Correlates of the 10 item Connor-Davidson Resilience Scale among Family Caregivers of Nigerian Patients with Psychiatric Disorder

Background: Despite studies in developed countries repeatedly reporting on the positive influence of resilience on the ability of family caregivers to withstand the burden of providing care for their relatives no literature is currently available regarding the construct and the factors associated with resilience among the family caregivers of Nigerian psychiatric patients. Methods: This is a cross-sectional descriptive study in which 234 family caregiver-patient dyads were consecutively recruited over a period of 6 months from the psychiatric outpatients’ clinics of two university teaching hospitals in South-western Nigeria. The caregivers completed the 10 item Connor-Davidson Resilience Scale (CDRISC-10) in addition to other measures. Exploratory factor analysis was used to evaluate the dimensionality of the scale. The scale’s reliability and validity were also examined. Results: Exploratory Factor Analysis revealed a uni-dimensional model of the 10 item CD-RISC among the family caregivers. Internal consistency of the scale’s items was modestly satisfactory (Cronbach’s alpha 0.87). The evidence for the convergent validity of scale was provided by statistically significant correlations with the family caregivers’ scores on the Zarit Burden Interview (r =0.276, p<0.001), MINI Suicidality module (r=0.312, p<0.001), General Health Questionnaire-12 (r =0.220, p<0.001) and Patient Health Questionnaire-9 (r=0.282, p<0.001). Hierarchical linear regression analyses showed that, the main variance in the family caregivers’ score on the CDRISC-10 was accounted for by the MINI Suicidality module. Conclusions: The scale has exhibited satisfactory psychometric qualities as a tool for the assessment of resilience among the family caregivers of Nigerian patients with psychiatric disorders in terms of its reliability and validity. Our study further affirms that the construct of resilience measured with the 10 item CDRISC is best explained by a one dimensional factor.

Trust in Physician Scale: Factor structure, reliability, validity and correlates of trust in a sample of Nigerian psychiatric outpatients

BACKGROUND Trust is essential in the patient-physician relationship and has not been explored among Nigerian psychiatric outpatients. OBJECTIVES The purpose of this study was to evaluate the psychometric characteristics of the Trust in Physician Scale among a cross-sectional sample of stable Nigerian outpatients receiving treatment for psychiatric disorders. METHODS A consecutive sample of outpatients attending a Nigerian university teaching hospital psychiatric clinic in South-western Nigeria completed the scale (N=223). Factorial analysis, internal consistency, validity and correlates of the scale were evaluated. RESULTS The structure of the Trust in Physician Scale was best explained by a 2 factor construct. Cronbachs alpha was 0.68, indicating a rather modest degree of internal consistency. The 2 factors extracted also had modest internal consistencies (Cronbachs alpha 0.66 and 0.76). A fair degree of construct validity was indicated by weak positive correlation of trust with medication adherence and the numbers of previous admissions. The mean trust score was relatively high. Significant positive correlations were observed between trust scores and adherence score, number of previous admissions and the number of schizophrenic relapses. CONCLUSION The results suggest that despite the comparatively weak psychometric properties of the Trust in Physician Scale, it is still useful in the evaluation of trust among Nigerian psychiatric outpatients. More studies are needed to further explore and compare the properties of this scale across a wider range of patient groups in Nigeria, and to identify other factors that could interact with trust among the different patient populations in our environment.

Adaptation of the Beck Hopelessness Scale as a suicide risk screening tool among Nigerian patients with schizophrenia

Abstract Objectives: We examined the adaptation of the Beck Hopelessness Scale (BHS) as a subjective suicide risk assessment tool in detecting Nigerian patients with schizophrenia who are at a high risk of suicide. Methods: Schizophrenia patients (211) completed the BHS in addition to a sociodemographic questionnaire. They were objectively interviewed with the suicidality module of the Mini International Neuropsychiatric Interview (MINI) as the ‘gold standard’, against which the criterion validity of the BHS was examined. Results: The receiver operating characteristics (ROC) curve of the 20-item BHS scale at a total cut-off score of 9 (sensitivity 0.889, specificity 0.916) against the patients’ MINI Suicidality Module risk categorisation had an Area Under the Curve (AUC) of 0.96 (95% CI: 0.928–0.987), while, the four-item BHS scale demonstrated a ROC curve with an AUC of 0.92 (95% CI: 0.868–0.966) at a cut-off score of 1 (sensitivity 1.000, specificity 0.832). Conclusions: The BHS has proven to be valid in terms of its sensitivity and specificity in the identification of the high suicidal risk Nigerian schizophrenia outpatients.

Psychometric Adaptation of the Beck Hopelessness Scale as a Self-Rated Suicide Risk Screening Instrument Among Nigerian University Students:

BACKGROUND: Globally, suicide is the most important cause of mortality among adolescents and young adults. The factor that correlates most significantly with suicide is hopelessness. OBJECTIVE: The aim is to explore the psychometric adaptation of the Beck Hopelessness Scale (BHS) as a suicide risk evaluation tool among Nigerian university students. DESIGN: A total of 554 Nigerian students completed the BHS and the Depression Anxiety Stress Scale (DASS). Suicide risk level among them was determined by interviewing them with the Mini International Neuropsychiatric Interview Suicidality module. RESULTS: Cronbach’s alpha for the 16-item BHS was 0.87. It exhibited satisfactory concurrent validity with the Mini International Neuropsychiatric Interview (MINI) Suicidality module and the subscales of the DASS among the students. The 2-factor model of the BHS-16 exhibited satisfactory indices of fitness (goodness of fit index = 0.930; parsimonious goodness of fit index = 0.601; comparative fit index = 0.934; incremental fit index = 0.936; Tucker–Lewis index = 0.910; root mean square error of approximation = 0.059; χ2/df = 1.9). Receiver operating characteristics curve indicated that the best cutoff score for those categorized as high suicide risk was 7 (sensitivity 0.700, specificity 0.908, AUC = 0.897). CONCLUSIONS: The BHS has satisfactory psychometric properties as a suicide risk screening tool among Nigerian university students.

Obsessive-compulsive inventory-revised: Factor structure, reliability, validity, and suicide risk screening characteristics among nigerian patients with schizophrenia

Objective: This study attempted to explore the feasibility of use of the 18-item Obsessive-Compulsive Inventory-Revised (OCI-R) as a subjective suicide risk assessment tool in a cross-sectional sample of Nigerian patients with schizophrenia. Materials and Methods: Two hundred and thirty-two outpatients with schizophrenia were recruited from the mental health clinic of a university teaching hospital in Southwestern Nigeria. They completed the OCI-R in addition to the Social and Occupational Functioning Assessment Scale, the Positive and Negative Syndrome Scale, and a sociodemographic and illness-related questionnaire. The patients were objectively interviewed with the Mini-International Neuropsychiatric Interview suicidality module items to assess their suicide risk. Results: The 18-item OCI-R demonstrated satisfactory sensitivity (0.900) and specificity (0.662) at a total cutoff score of 10 in relation to the identification of Nigerian patients with schizophrenia with significant suicide risk. At this cutoff score, the area under the receiver operating characteristic curve was 0.817 (95% confidence interval: 0.735–0.898), and positive predictive value (0.726) and negative predictive value (0.869) were also satisfactory. The OCI-R also demonstrated satisfactory internal consistency and construct validity. Conclusion: The OCI-R has demonstrated to be useful as a subjective suicide risk assessment tool among Nigerian schizophrenia patients.

Sleep Hygiene Index: Psychometric Characteristics and Usefulness as a Screening Tool in a Sample of Nigerian Undergraduate Students

STUDY OBJECTIVES The objectives of this study were to investigate the psychometric properties of the Sleep Hygiene Index (SHI) and determine its capacity to screen for poor sleep quality in a nonclinical sample of Nigerian university students. METHODS A total of 348 students appropriately completed the SHI, the Morningness-Eveningness Questionnaire (MEQ), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). RESULTS The internal consistency (Cronbach alpha) of the SHI was .64 and its construct validity was modestly satisfactory. It had a significant negative correlation with the MEQ (r = -.170, P < .001) and positive correlations with global PSQI (r = .289, P < .001) and ESS (r = .219, P < .001) scores. Prior to the factor analysis, our sample was randomly divided into two. In one half of the sample (sample 1), exploratory factor analysis of the SHI items yielded a three-factor model. Confirmatory factor analysis on the other half (sample 2) corroborated this model with satisfactory indices of fitness (c2 = 67.805; df = 55; c2/df = 1.233; P = .115; goodness of fit index = .943; Tucker-Lewis index = .958; incremental fit index = .972; comparative fit index = .970; root mean square error of approximation = .037). A cutoff total score of 16 on the SHI had the best sensitivity (77.0%) and specificity (47.5%) to identify students who were categorized as experiencing poor sleep quality, according to the PSQI (area under the curve = 0.65, 95% confidence interval = 0.59-0.71). CONCLUSIONS The SHI exhibited satisfactory psychometric properties as a self-rated assessment instrument in the evaluation of sleep hygiene and as a screening instrument for poor sleep quality among Nigerian undergraduate students.