Victor O. Lasebikan

Family Burden in Caregivers of Schizophrenia Patients: Prevalence and Socio-Demographic Correlates

Background: This study aims to determine the prevalence and socio-demographic correlates of caregivers burden in schizophrenia. Materials and Methods: A dyad of 368 schizophrenia patients and their caregivers were interviewed. Caregivers burden was assessed using the Yoruba-version of the FBIS and GHQ-12. Results: Mean age of patients was 29.7 SD (8.6) years. Of the 368 caregivers, 81.5% were parents, mean age was 58.1 years (SD 19.6). Total mean objective FBIS score was 22.69 (6.21), 324 (85.3%) reported total objective burden and 310 (84.2%), subjective burden. There were significant differential demographic associations with caregivers’ burden. Conclusion: Caregivers of schizophrenia patients experience enormous burden and are potential “high risk group” for mental disorders. Thus, they require comprehensive intervention in order to reduce the growing incidence of chronic enduring diseases including mental disorders.

Prevalence and Correlates of Alcohol Use among a Sample of Nigerian Semirural Community Dwellers in Nigeria

Objective. To determine the prevalence and correlates of alcohol use among a sample of Nigerian semirural community dwellers in Nigeria. Methods. In a single arm nonrandomized intervention study, the assessment of baseline hazardous and harmful alcohol use and associated risk factors was conducted in two semirural local government areas of Oyo State, Nigeria, with the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Participants included 1203 subjects 15 years and older, recruited between October 2010 and April 2011. ASSIST score of 0–10 was classified as lower risk scores, 11–26 as moderate risk, and 27+ as high risk. Results. Prevalence of lifetime alcohol use was 57.9% and current alcohol use was 23.7%. Current alcohol use was more prevalent among the younger age group p = 0.02, male gender p = 0.003, unmarried p < 0.01, low educational level p = 0.003, low socioeconomic class p = 0.01, unemployed p < 0.001, and the Christians p < 0.01. Of the current drinkers, the majority (69.1%) were at either moderate or high health risk from alcohol use. Conclusion. Alcohol consumption is prevalent in semirural communities in Nigeria and the majority of these drinkers are at moderate or high health risk. Screening, brief intervention, and referral for treatment for unhealthy alcohol use should be integrated into community care services in Nigerian rural communities.

Effects of Psychopathology, Functioning and Anti-Psychotic Medication Adherence on Caregivers' Burden in Schizophrenia

Background: The aim of the study was to determine the effects of the level of psychopathology and anti-psychotic medication adherence on caregivers’ burden in schizophrenia. Materials and Methods: Three hundred and sixty-seven schizophrenia patient/caregiver dyads were interviewed. Caregivers burden was assessed using the Yoruba version of the Family Burden Interview Schedule (FBIS) and 12-Item General Health Questionnaire (GHQ-12). Patients were assessed using the Global Assessment of Functioning (GAF) scale, Positive and Negative Symptoms Scale (PANSS), and medication compliance questionnaire. Results: Mean age of the patients was 29.7 SD (8.6) years. About 82% of the 368 caregivers were parents of the patients with mean age of 58.1 years (SD 19.6). Total mean objective FBIS score was 22.69 (6.21), with 324 caregivers (85.3%) reporting total objective burden and 310 (84.2%) reporting subjective burden. FBIS scores were positively associated with PANSS scores but negatively with GAF P<0.001, respectively. Mean FBIS reduced with medication compliance categories A and B, P<0.01, respectively, but increased in category F, P<0.001. In all, 51.1% scored ≥3 on GHQ. Conclusion: Caregivers of schizophrenia patients experience enormous burden and are at risk for mental disorders. The severity of this burden is related to the level of psychopathology and medication adeherence, thereby adding to the available evidence pointing to the need for clinicians to optimize patients’ management to prevent psychological distress in carers of such patients.

Cultural aspects of mental health and mental health service delivery with a focus on Nigeria within a global community

ABSTRACT With an endless range of subgroups and individual variations, culture bears upon what all people bring to the clinical setting. Culture could account for health-seeking behaviour, type of services and support system and variations in how people communicate their health concerns. Culture may underlie presentation of sets of symptoms that are peculiar to certain societies – culture-bound syndromes. Culture also influences the meanings that people impart to their illness and also stigma associated with such illnesses. Culture must be viewed from the patients, clinicians and health system dimensions. Changes in mental health service delivery in last few decades have yielded culturally competent mental health services. The aim of this paper was to discuss culture and mental health with a focus on Nigeria and from a global perspective.

Prevalence of alcohol consumption and alcohol use disorders among outdoor drinkers in public open places in Nigeria

BackgroundThere is a rapid shift in the social context of drinking, with a large proportion of regular drinkers favouring outdoor-open space drinking, such as motor-parks, by the road sides, the majority of which are unlicensed premises for drinking.MethodThis study determined the prevalence and determinants of harmful or hazardous alcohol use and possible dependence, defined as a “likely alcohol use disorder” (AUD) in a community sample of 1119 patrons of open space drinking places in Ibadan, Nigeria, using the AUDIT. Scores of 8 and above signified a likely AUD. The associations between a likely AUD and demographic characteristics were sought using Chi square statistics and binary regression analysis was used to determine the effects of multiple confounding variables on a likely AUD using the SPSS version 20.0 software.ResultsOf the entire population, the prevalence of likely AUD was 39.5%, and 44.4% out of the drinking population Multivariate analysis showed that Islamic religion was a negative predictor for likely AUD, OR = 0.13, 95% CI (0.06–0.26), while rural residence, OR = 1.84, 95% CI (1.34–2.53) and cigarette smoking OR = 1.81, 95% CI (1.37–2.40) were predictive of likely AUD.ConclusionOutdoor-open space drinkers are likely to have AUD compared with the general population. Open space drinking has a huge public health implication because of the associated health risks and injuries.

Vitamin D Levels in Different Severity Groups of Schizophrenia

Background Vitamin D deficiency (VDD) continues to be associated with schizophrenia, but there is the dearth of information on the relationship between the severity of schizophrenia and plasma levels of vitamin D. This study, therefore, determined the plasma levels of vitamin D in different severity groups of schizophrenia. Materials and methods Plasma level of vitamin D was determined in 60 patients with schizophrenia and 30 apparently healthy individuals who served as controls. Patients with schizophrenia were classified into mildly ill, moderately ill, markedly ill, and severely ill groups using the Positive and Negative Syndrome Scale (PANSS). Results The mean level of vitamin D was significantly lower in patients with schizophrenia compared with the controls. Similarly, there was a significant association between VDD and schizophrenia. The mean plasma levels of vitamin D were not significantly different when the mildly, moderately, markedly, and severely ill groups were compared with one another and there was no significant correlation between vitamin D level and PANSS scores. Furthermore, patients on atypical antipsychotics had an insignificantly lower level of vitamin D compared with the patients on typical antipsychotics. Conclusion It could be concluded from this study that patients with schizophrenia have low plasma vitamin D level which does not appear to be associated with the severity of schizophrenia and type of antipsychotics. Therefore, regular screening for vitamin D status of patients with schizophrenia is suggested in order to allow for the institution of appropriate clinical intervention when necessary.

Lifetime and 12 Months Prevalence of Alcohol Use and Alcohol Use Disorders Among Soldiers Residing in a Military Community in Ibadan

ABSTRACT Objective: Aims of the study were to determine lifetime and 12 months prevalence of alcohol use and alcohol use disorders and the profile of problems associated with the diagnoses of alcohol use disorders among a military population in Nigeria. Method: In this descriptive cross-sectional study, 223 military officers were interviewed by multistage stratified systematic sampling method. The Composite International Diagnostic Interview (CIDI) version 7.0 was used to generate data on prevalence of lifetime and current alcohol use, alcohol use disorders, and associated profile of problems. Chi square statistics, Wilcoxon-signed rank test, and binary regression analysis were used to explore the correlates of alcohol use and alcohol use disorder. All analyses were carried using SPSS Version 17.0. Results: Prevalence of lifetime alcohol use was 76.0%, 12 months prevalence was 53.9%, and frequent binge drinking was reported in 6.7% of respondents. Predictors of lifetime alcohol use were: Hausa/Fulani ethnicity OR = 1.51, 95% CI (1.11–8.71), Igbo ethnicity OR = 1.46, 95% CI (1.09–7.01), involvement in combat OR = 1.41, 95% CI (1.01–6.16). Predictors of 12 months alcohol use were: Hausa/Fulani ethnicity OR = 1.98, 95% CI (1.25–8.71), involvement in combat OR = 1.39 95% CI (1.01–5.28) and junior rank soldier OR = 2.08, 95% CI (1.47–8.99) while predictors of lifetime alcohol use disorders were: Hausa/Fulani ethnicity OR = 2.22, 95% CI (1.03–6.99) and involvement in combat OR = 2.04 95% CI (1.12–6.81). Conclusion: Alcohol misuse is highly prevalent in the Nigerian military and its associated factors exemplify the common “military drinking culture.”

Lifetime and 12 months cannabis use and disorders among soldiers residing in a military community in Nigeria

ABSTRACT Objective: The main aim of the study was to determine the lifetime and 12 months prevalence of cannabis use and cannabis use disorder (CUD) and their correlates among a military population in Nigeria. Method: Military officers (N = 223) were interviewed in this descriptive cross-sectional study. The Composite International Diagnostic Interview 7.0 was used to generate data on prevalence of cannabis use and to obtain the diagnosis of CUD. Results: Prevalence of lifetime cannabis was 13.5%, 12 months (6.8%), lifetime cannabis abuse (4.9%), lifetime cannabis dependence (0.9%), lifetime CUD (5.8%), and 12-month CUD (2.2%). Predictors at 95% CI of lifetime cannabis use include: elementary education OR = 2.23 (1.13–5.23), Hausa ethnicity/Fulani OR = 2.30, (1.34–5.82), minority tribes OR = 1.33 (1.12–3.66), ever received disciplinary action OR = 1.77, (1.19–5.64), ever deployed to operational areas OR = 1.12 (1.02–3.21), and ever injured in combat OR = 2.45, (1.39–7.41); and predictors of 12 months cannabis use include: elementary education OR = 1.78 (1.09–4.62), Hausa/Fulani ethnicity OR = 2.06 (1.27–533), the minority tribes OR = 1.42 (1.08–4.58), and ever injured in combat OR = 1.79 (1.04–5.21). Conclusion: Certain workplace factors, similar to other parts of the world, were associated with cannabis use in the Nigerian military.

Factors associated with paternal perinatal depression in fathers of newborns in Nigeria

Abstract Introduction: There is a lack of information on paternal postnatal depression in developing countries such as Nigeria. Methods: This study aims to assess the prevalence of depression in fathers at the birth of their infants and the incidence of paternal postnatal depression at 6 weeks postpartum. We also examined the correlation between paternal postpartum depression (PPD) at 6 weeks and maternal PPD as well as the sociodemographic and other correlates of paternal PPD at 6 weeks. Results: All the 331 fathers recruited at baseline completed the study. Prevalence of depression in fathers at birth of their babies was 10 (3%). After excluding the 3%, the incidence of PPD in fathers (N = 321) at 6 weeks was 19 (5.9%). In all, 29 (8.8%) fathers had PPD. The prevalence of depression in mothers at 6 weeks postpartum was 57 (17.8%). The prevalence of depression in mothers at 6 weeks was significantly higher than the incidence of depression in fathers at 6 weeks (X2 = 26.2, p < .001). There was no significant correlation between maternal PPD and paternal PPD. At baseline, prevalence of PPD among the unemployed fathers was higher than in the employed, 3 (21.4%) versus 7 (2.2%), this was significant (FE p < .01). There was no significant correlate of paternal PPD at 6 weeks. Discussion: Postpartum mental health services should be extended to fathers of newborns especially those who are unemployed. Our findings have implications for family health.

Profile and Determinants of Disability in Psychotic Disorders in Nigeria

We compared profile and predictors of disability among 210 patients with schizophrenia, schizoaffective disorder, bipolar I disorder with psychosis and depression with psychosis, respectively in a Nigerian clinical population, using the WHO Disability Assessment Schedule, (2.0). Severity of psychosis was determined with Positive and Negative Symptoms Scale, functioning was assessed using the Global Assessment of Functioning Scale, medication adherence with the Medication Adherence Questionnaire. Analyses were by SPSS 20.0. There were remarkable differences in the predictors of disability across these psychotic disorders. The findings strengthens the significance of psychosocial rehabilitation in patients with psychosis as clinical remission and medication adherence did not equate functional recovery.