The Impact of 6-month Micronutrient Supplementation on Viral, Immunological, and Mental Health Profile of a Cohort of Highly Active Antiretroviral Therapy-Naive HIV-Positive Patients in Northern Nigeria.

BACKGROUND: HIV is a chronic disease with inflammatory reactions involving numerous elements of the immune system, resulting in an increased risk for other physical and psychiatric morbidities. Micronutrients, some of which possess anti-inflammatory properties, may help prevent the development of psychological disorders such as anxiety and depression in people living with HIV disease. OBJECTIVES: This study examined the profile of viral load, CD4 cell count, C-reactive protein, anxiety, and depression among highly active antiretroviral therapy (HAART)-naive HIV-positive patients receiving micronutrient supplementation over a 6-month period. MATERIALS AND METHODS: A total of ninety HAART-naïve HIV-infected patients completed the Hospital Anxiety Depression Scale. Their blood samples were taken for serum viral load, CD4 cell count, and C-reactive protein at baseline. They all received a micronutrient supplement for 6 months, and 68 participants who remained in treatment at 6 months were reassessed with the same parameters. RESULTS: After 6 months of micronutrient supplementation, the participants were found to have statistically significantly lower mean scores on the anxiety (t-test = 2.970, P = 0.003) and depression (t-test = 3.843, P = 0.001) subscales. They also had statistically significantly lower median CD4 cell count (P = 0.00) and C-reactive protein serum measures (P = 0.04). The median viral load decreased although the difference was not statistically significant. CONCLUSION: Micronutrient supplementation may reduce inflammatory reactions, anxiety, and depression in HAART-naive HIV-infected persons.

Psychometric validity of the distress thermometer and problem check list in ART-naïve HIV infected patients in Northern Nigeria.

BACKGROUND: HIV diagnosis comes with a lot of worry and distress. Ability to objectively estimate this distress by non-psychiatrist will enhance early detection of psychological distress for intervention. OBJECTIVES: To investigate the validity of the Distress Thermometer (DT) and its problem checklist in achieving early detection of mental distress among ART-naïve HIV infected patient. MATERIALS AND METHODS: A total of 90 ART-naïve HIV infected patients completed the DT and its problem check list, Hospital Anxiety Depression Scale (HADS), Oslo Social Support Scale and the 14-item Resilience Scale. RESULTS: The DT was positively correlated with all the measures of distress and reversely correlated with all the positive wellness in this study. The correlations were only significant for the negative measures of psychological wellness. The internal consistency of the DT's problem list overall and sub-categories were within acceptable range (i.e. α > 0.50). The Receiver Operating Characteristic (ROC) curves and Area Under the Curves (AUC) analysis were significant and found the DT and Problem List to respectively differentiate between cases of distress, anxiety and depression. The DT's cut-off was >5.0 with AUC range (0.754 - 0.709); sensitivity range (81.0% - 70.4%); specificity range (68.3% - 65.2%) for distress, anxiety and depression as determined by HADS. And the Problem List cut-off was >6.0 with AUC range (0.854 - 0.821); sensitivity range (90.5% - 85.7%); specificity range (68.3% - 65.2%) for distress, anxiety and depression as measured by HADS. CONCLUSION: The DT and Problem List were found to be valid measures of distress in ART-naïve HIV infected patients.

Assessing Change Readiness and Treatment Eagerness among Psychoactive Substance Users in Northern Nigeria.

Studies on psychoactive substance use in Nigeria had focused on prevalence and rarely on treatment implication(s) of large rates reported. Further challenge was to find suitable instruments to monitor change readiness as well as predict treatment outcomes along motivation continuum and according to resilience characteristics. Such ability will not only help to match treatment strategy with stage of change but also come with a more satisfactory outcome. This study therefore provided psychometric properties of one of such measuring scales: Stage of Change Readiness and Treatment Eagerness Scale version 8 (SOCRATES-8) and the accompanying change in resilience among Nigerians using psychoactive substances. Participants were 111 psychoactive substance dependent users in three treatment centers in Northern Nigeria. All respondents filled sociodemographic questionnaire, SOCRATES-8 and 14-item Resilience Scale. The study found overall motivation for change among participants to be medium on the three subscales of SOCRATES-8: ambivalence (median=14.00; range=7-20); recognition (median=31.00; range=7-35); and taking steps (median=35.00; range=12-40). More than half (61.3%) scored moderately on resilience. The Internal reliability of SOCRATES-8's subscales fell into acceptable range (ambivalence=0.54; recognition=0.87; taking steps=0.84). Pearson correlation coefficients of subscales with resilience are positive and in moderate range except for ambivalence with very low coefficient. Hierarchical cluster analysis based on participants' resilience characteristics yields five distinct profiles corresponding to five stages of motivational change. ANOVA of these five profiles based on SOCRATES' 3 subscales was significant. The study demonstrates utility of SOCRATES-8 to assess change readiness and treatment eagerness of psychoactive substance abusers according to stages of change and their resilience characteristics. This will aid treatment planning and can also measure treatment outcome.

Psychometric assessment of the Wagnild and Young's resilience scale in Kano, Nigeria.

BACKGROUND: Resilience seemed to lie at the core of the recent promotion of positive mental health and wellbeing. This concept has been well studied in western countries and less in developing countries, particularly Nigeria. The aim of the study is therefore, to demonstrate the internal consistency and concurrent validity of the Resilience Scale (RS) and its 14-item short version (RS-14) in a Nigerian sample. RESULTS: The RS, RS-14, the Hospital Anxiety Depression Scale (HADS) and two screening questions on experience of recent and upcoming distress were administered to 70 clinical students who consented to participate after a major professional examination. Internal consistency and convergent validity were assessed. The participants mean age was 22.50 years (SD = 0.60). The mean score of RS and RS-14 were 130.23 (SD = 17.08) and 74.17 (SD = 10.14) respectively. Cronbach's alpha coefficient for the RS was 0.87 and that of the RS-14 was 0.81. The mean RS score by gender was 132.04 (SD = 19.08) and 126.52 (SD = 11.50) for males and females respectively and the difference was significant (t = 2.50; p = 0.012). The correlation of RS with RS-14 (r = 0.97; p = 0.000), the HADS depression (r = -0.28; p = 0.017) and anxiety (r = -0.26; p = 0.028) subscales, were significant. The corresponding t-test values for the means of RS and RS-14 scores for both cases and non-cases as determined by HADS, were significant at p < 0.05 and p < 0.01 for the depression and anxiety subscales respectively. The difference between RS means of those who experienced distress (38/125.69) to those that did not (32/134.05) from the recent clinical examination was also significant (t = 2.01; p = 0.045). CONCLUSIONS: The study confirms that the RS and RS-14 may be potentially useful instruments to measure resilience in Nigerians.

A comparative study of aggression amongst Nigerian university students in Niger Delta region.

There is genuine concern over social violence and aggression among youths in many countries. Despite considerable efforts directed toward molding the pattern of model behavior, frequent disturbances and various antisocial vices among youths in our environment may be due to failure to acknowledge the risk factors associated with aggression. The objective of this study was to assess the level of aggressive traits among students in higher institutions, as well as identifying the possible predictive factors. Using a two-stage random sampling method, 515 fifteen students, comprising 306 from arts and 209 from medicine faculties, University of Uyo were screened for aggressive traits; using Buss-Perry Aggression (BPAQ) Questionnaire. A total of 306 arts students and 209 medical students fully completed the questionnaire. Among the arts students, 127 (41.5%) were males and 179 (58.5%) females. Similarly, of the 209 medical students, 143 (68.4%) were males and 66 (31.6%) females. The mean age for arts students was 28.7 years (SD = 7.9); while that of medical students was 23.6 years (SD = 4.9). The difference in the mean was statistically significant (t = 8.15, P = 0.001). A total of 139 (45 .4%) of arts students showed abnormal overall score for aggression as against 74 (35.4%) of medical students. This difference was statistically significant (χ(2) = 5.139, P = 0.01). There was also significant difference in the physical and verbal aggression subscales as 123 (40.2%) of arts against 53 (25.4%) medical students showed physical aggression (χ(2) = 12.15, P = 0.001), while 82 (26.8%) against 109 (52.2%) showed verbal aggression (χ(2) = 34.218, P = 0.001). Verbal aggression was positively correlated with female students; males have 2.98 odds ratio of being aggressive (P = 0.001). There is a high level of aggressive traits among students in higher institutions of learning. This can manifest in behaviors and vices capable of disturbing public peace and academic activities in schools. Therefore, there is need to curb aggression in order to create conducive learning environment and maintain societal norms.