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.

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.

Assessing the psychological well-being of caregivers of people living with HIV/AIDS in Niger Delta region, Nigeria.

Despite the availability of anti-retroviral drugs and treatment, the care and support of people living with HIV/AIDS has continued to be a major challenge, with greater impact not only on the people living the disease. The burden associated with care often results in high level of stress among caregivers, usually manifesting as anxiety and/or depression. This study assesses the levels of stress among caregivers of people living with HIV/AIDS in Niger Delta region of Nigeria, in order to determine their coping strategies. Between July and December 2008, 322 caregivers of people living with HIV/AIDS attending HIV clinic of the University of Uyo Teaching Hospital were randomly assessed for stress (anxiety and depression), using Zung's Self-Rating Depression Scale (SDS) and Self-Report Questionnaire (SRQ-20). A total of 293 caregivers comprising 98 (33.4%) males and 195 (66.6%) females were analysed. Mean age of males was 44.0 ± 4.5 years and females was 39.3 ± 4.0 years. The difference in the mean was statistically significant (p<0.001). Of the 293 caregivers, 191 (65.2%) and 115 (39.2%) were scored high on SDS and SRQ-20, respectively (representing the levels of stress). Using SDS groups on SRQ-20 subscales, 134 (45.7%) had anxiety only, 23 (7.8%) depression only, 52 (17.7%) had a mixture of anxiety and depression, while 11 (3.7%) exhibited suicidal tendencies. There is increasing level of stress in caregiving. Therefore, adequate attention must be given to the psychological well-being of caregivers to enable them contribute positively to the care of people living with HIV/AIDS.

Demographic risk factors in domestic violence among pregnant women in Uyo, a community in the Niger Delta region, Nigeria.

There has been increasing global concern about the level of violence against pregnant women. Anecdotal evidence from general observations shows that there may be higher prevalence in the Niger Delta region of Nigeria. Unfortunately, in spite of the emerging and alarming social indicators for violence against women in the area, little effort has been made to address this dangerous trend. One major concern has been the effects of violence on pregnancy and the difficulty in protecting the pregnant women, since managing violence is often unsuccessful. There is therefore the need to evaluate the magnitude, as well as the risk factors for violence and the sociodemographic characteristics of the women, for purposes of prevention.

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.

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

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.

Stigmatising attitude of medical students towards a psychiatry label.

BACKGROUND: The 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. METHODS: A 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. RESULTS: A 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. CONCLUSION: These results strengthen the view that stigma attached to mental illness is not limited to the general public; medical students are also part of the stigmatizing 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.

A comparative study of HIV/AIDS: the knowledge, attitudes, and risk behaviors of schizophrenic and diabetic patients in regard to HIV/AIDS in Nigeria.

CONTEXT: Studies on knowledge and risk behaviors related to HIV/AIDS reported from developed countries have shown that people with psychiatric disorders constitute a special risk group. In Nigeria, although similar studies have been conducted on various population groups, there has, so far, been no reported study on people suffering from psychiatric disorders. OBJECTIVE: The present study set out to compare knowledge, attitudes, and risk behaviors related to HIV/AIDS among schizophrenic patients and diabetic patients. METHOD: Ninety-eight consecutive schizophrenic patients attending the outpatient clinics of a psychiatric hospital over a period of 8 weeks completed an interviewer's administered questionnaire. The interview covered demographics, risk behaviors, knowledge related to HIV/AIDS, and patients' attitudes toward people infected with HIV/AIDS. Their responses were compared with those of 56 diabetic patients who were similarly interviewed in a teaching hospital. RESULTS: Compared with the diabetic patients, the schizophrenic patients were significantly less sexually active in the previous 12 months (P < .05). They had more misconceptions about HIV/AIDS and were less tolerant towards people living with HIV/AIDS compared with the diabetic patients. They were also more likely to engage in high-risk behaviors. CONCLUSION: Mental health providers rarely educate psychiatric patients about HIV/AIDS and should be more involved in doing so. Despite being less sexually active, patients with schizophrenia engaged in risk behaviors as did the diabetic patients.