Psychometric evaluation of personal evaluation of transitions in treatment amongst patients with schizophrenia.

BACKGROUND: Monitoring the antipsychotic medication adherence of outpatients with schizophrenia has focused majorly on the medication construct of adherence, whilst neglecting its psychosocial construct. AIM: The aim of this study was to provide the psychometric properties of personal evaluation of transitions in treatment (PETiT). SETTING: This study was conducted at the Neuropsychiatric Hospital, Aro, Abeokuta, Ogun State, Nigeria. METHODS: This is a study of diagnostic accuracy of patients with a diagnosis of schizophrenia. Calculation of the sample size and oversampling was calculated as proposed by Cochrane. RESULTS: The Cronbach's α in this study at baseline was 0.82. Intra-class correlation coefficient was 0.81 (p ≤ 0.001). Medication construct was loaded into two factors or components whilst the psychosocial construct was loaded into four factors. CONCLUSION: The data depicted here indicated a successful validation and presentation of psychometric properties of PETiT which is self-administered, user friendly, psychometrically sound and sensitive to changes associated with treatment over time.

Relationship between quality of life and social integration among patients with schizophrenia attending a Nigerian tertiary hospital.

BACKGROUND: Despite decades of de-institutionalization and the best efforts of community mental health services, individuals with schizophrenia living outside the hospital may be described as in the community but not of the community, and remain in a very real sense socially excluded. AIM AND OBJECTIVES: To determine the relationship between social integration and quality of life among patients with schizophrenia attending the outpatient clinic of the Neuropsychiatric Hospital Abeokuta in Nigeria. METHODS: One hundred and fifty-one patients were recruited. Sociodemographic questionnaire, MINI-PLUS, WHOQOL-BREF, Social Integration Scale and PANSS were administered. Multivariable regression analyses were performed to identify the determinants of quality of life and the relationship with social integration. RESULTS: The mean (± SD) age of the respondents was 40.00 (± 10.23), 56.3% were males, 37.1% were single. Independent predictors of lower quality of life were: (1) more severe psychopathology for the domains of general health (p = 0.003), social relationship (p = 0.019) and environment (p = 0.008); (2) longer duration of illness for the social relationship (p = 0.028) and environment (p = 0.015) domains; and (3) negative symptoms (p = 0.034) for the physical domain. CONCLUSION: There is a need to pay closer attention to social outcome measures such as quality of life and level of social integration among patients with schizophrenia who come in contact with psychiatry services, and not just on symptom remission only.

Psychoactive substance use among outpatients with severe mental illness: A comparative study.

BACKGROUND: Despite several studies on the prevalence and pattern of substance use in Nigeria, there is little information on substance use in patients diagnosed with serious mental illness (SMI) such as schizophrenia and bipolar affective disorder (BD). AIM: The aim of the study was to compare the pattern of psychoactive substance use among outpatients with BD and schizophrenia. SETTING: The study was conducted in a neuropsychiatric hospital in Nigeria. METHODS: Seventy five consecutive patients with a MINI-PLUS diagnosis of BD were compared with an equal number of patients obtained by systematic random sampling with a MINI-PLUS diagnosis of schizophrenia. RESULTS: The respondents with schizophrenia were aged 18-59 years (37.2 ± 9.99) and were predominantly young adult (49, 65.3%), men (46, 61.3%), who were never married (38, 50.7%). Overall, lifetime drug use prevalence was 52%, while for current use, overall prevalence was 21.3%. Participants with BD were aged 18-63 years (36.7 ± 10.29) and were predominantly young adult (53, 70.7%), women (44, 58.7%), who were married (32, 42.7%), with tertiary education (31, 41.3%). Overall, lifetime drug use prevalence was 46.7%, while current overall prevalence was 17.3%. These rates (lifetime and current) for both diagnostic groups are higher than what was reported by the World Health Organization in the global status report of 2014 (0% - 16%). The statistically significant difference between the two diagnostic groups was related to their sociodemographic and clinical variables and psychoactive substance use. CONCLUSION: Psychoactive substance use remains a burden in the care of patients diagnosed with schizophrenia and BD. Future policies should incorporate routine screening for substance use at the outpatient department with a view to stemming the tide of this menace.

Psychosocial correlates of hazardous alcohol use among undergraduates in southwestern Nigeria.

OBJECTIVE: The aim of this study was to examine the relationship between alcohol use and psychological well-being among undergraduates of a Nigerian tertiary institution. The objectives included determining the prevalence and pattern of problematic alcohol use and ascertaining the association between alcohol use and some sociodemographic variables. METHOD: The Alcohol Use Disorders Identification Test (AUDIT) was used to evaluate for alcohol-related problems in 443 students of a university in southwestern Nigeria. A questionnaire was also used to obtain data on sociodemographic variables while psychological well-being was assessed with the General Health Questionnaire-28. RESULTS: The prevalence of alcohol use was 40.6% while alcohol-related problems were found in 14.9% of the students using the AUDIT questionnaire with a cutoff score of 5. Heavy episodic alcohol use was reported by 31.1% while alcohol-related injury had occurred in 8.9% of the students. Male gender (χ2=4.54; P<.05), older age (χ2=3.92; P<.05) and higher paternal education (χ2=4.40; P<.05) were associated with problem drinking. In addition, psychological distress was significantly associated with heavy episodic drinking (χ2=9.58; P<.05) and history of alcohol-related injury (χ2=3.96; P<.05). CONCLUSION: The significant relationship between hazardous drinking and mental ill health among undergraduates in the institution suggests the need for integrating mental health services in screening, brief intervention and referral to treatment services in Nigerian university settings.

A descriptive survey of types, spread and characteristics of substance abuse treatment centers in Nigeria.

BACKGROUND: Nigeria, the most populous country in Africa and the 8th most populous in the world with a population of over 154 million, does not have current data on substance abuse treatment demand and treatment facilities; however, the country has the highest one-year prevalence rate of Cannabis use (14.3%) in Africa and ranks third in Africa with respect to the one-year prevalence rate of cocaine (0.7%) and Opioids (0.7%) use. This study aimed to determine the types, spread and characteristics of the substance abuse treatment centers in Nigeria. METHODS: The study was a cross sectional survey of substance abuse treatment centers in Nigeria. Thirty-one units were invited and participated in filling an online questionnaire, adapted from the European Treatment Unit/Program Form (June 1997 version). RESULTS: All the units completed the online questionnaire. A large proportion (48%) was located in the South-West geopolitical zone of the country. Most (58%) were run by Non-Governmental Organizations. Half of them performed internal or external evaluation of treatment process or outcome. There were a total of 1043 for all categories of paid and volunteer staff, with an average of 33 staff per unit. Most of the funding came from charitable donations (30%). No unit provided drug substitution/maintenance therapy. The units had a total residential capacity of 566 beds. New client admissions in the past one year totalled 765 (mean = 48, median = 26.5, min = 0, max = 147) and 2478 clients received services in the non-residential units in the past year. No unit provided syringe exchange services. CONCLUSIONS: The study revealed a dearth of substance abuse treatment units (and of funds for the available ones) in a country with a large population size and one of the highest prevalence rates of substance abuse in Africa. The available units were not networked and lacked a directory or an evaluation framework. To provide an environment for effective monitoring, funding and continuous quality improvement, the units need to be organized into a sustainable network.