An exploratory study on the feasibility and appropriateness of family psychoeducation for postpartum women with psychosis in Uganda.

BACKGROUND: We explored how family psychoeducation could be made culturally sensitive for postpartum mothers with psychotic illness in a Ugandan setting. METHODS: A qualitative multi-method approach using an already existing family psychoeducation Tool Kit was adapted to incorporate lay perceptions related to psychotic illness in the postpartum period in this Ugandan setting. The participants consisted of postpartum women with psychotic illness, caregivers/family members, psychiatric nurses and psychologists. A modified version of a family psychoeducation programme for postpartum women with psychosis was formulated and pilot-tested. RESULTS: Modifications in the standard family psychoeducation programme were both in the process and content of family psychoeducation. Under process, effective communication, cultural background, appropriate dress, involving only one family member, low literacy, and flexibility in timekeeping were raised. The theme of content yielded the incorporation of lay perceptions of mental illness, family planning, income generating, and an emphasis of premorbid and morbid personalities of the patients. CONCLUSION: The basic principles and assumptions underlying psychoeducation remained the same. Changes made in the process and content of family psychoeducation reflected the social, cultural and gender reality of the population.

Cognitive and social functioning in recovery from depression: results from a population-based three-year follow-up.

BACKGROUND: This study prospectively examined cognitive and social functioning in recovery from depression using participants sampled from the general population. METHOD: Seventy-six depressed persons fulfilling (n=41) and not fulfilling (n=35) the criteria for DSM-IV depression at a three-year follow-up were compared with respect to episodic memory performance and social functioning at baseline (T1), at follow-up (T2) and change across time. RESULTS: The groups did not differ in episodic memory performance either at T1, T2 or in residual change. However, the groups differed in social functioning at T2 and in residual change indicating improved social functioning in the recovered group. LIMITATION: The absence of a healthy control group at follow-up. CONCLUSION: Despite the symptomatic improvement and improved social functioning, cognitive functioning does not follow this general recovery trend, at least not in the three-year interval examined.

Neuropsychological functions in anxiety disorders in population-based samples: evidence of episodic memory dysfunction.

Most of the available evidence on neuropsychological functioning in anxiety disorders is based on clinical samples, investigating persons affected by obsessive-compulsive disorder. Knowledge is sparse regarding cognitive functions in other types of anxiety disorders. The aim of this study was to examine whether persons diagnosed with an anxiety disorder show neuropsychological impairments relative to healthy controls in tasks tapping episodic memory, verbal fluency, psychomotor speed, and executive functioning. Population-based samples comprising individuals affected by panic disorder with and without agoraphobia or agoraphobia (n=33), social phobia (n=32), generalised anxiety disorder (n=7), obsessive-compulsive disorder (n=16), and specific phobia (n=24) were compared with healthy controls (n=175) in test performance. Overall, the total anxiety disorder group exhibited significant impairments in episodic memory and executive functioning. Separate analyses on the respective anxiety subgroup indicated that panic disorder with and without agoraphobia, and obsessive-compulsive disorder were related to impairments in both episodic memory and executive functioning. In addition, social phobia was associated with episodic memory dysfunction. Verbal fluency and psychomotor speed were not affected by anxiety. Specific phobia and generalised anxiety disorder did not affect neuropsychological functioning.

Adaptation of the multidimensional scale of perceived social support in a Ugandan setting.

BACKGROUND: The Multidimensional Scale of Perceived Social Support (MSPSS) was developed in the USA. The adequacy of its use in Uganda to guarantee its reliability and validity has not been ascertained. AIM: Thus the aim of the present study was to adapt the MSPSS scale by testing the validity and reliability of the scale in a Ugandan setting. METHODS: A cross-sectional design was employed and 240 respondents were consecutively recruited from postnatal clinics in Mulago hospital. Analysis of reliability and validity of the adapted MSPSS was done. Cronbach alpha and principal component analyses were respectively generated. RESULTS: Three subscales of the MSPSS that had been identified in other populations were evident in the Ugandan population. Using the Cronbach's alpha, the MSPSS demonstrated good internal consistency at .83. A dendrogram indicated that all sub items of the MSPSS were inter-linked. Exploratory Factor analysis derived three components. Principal Component analysis using rotated varimax generated high loadings on all subscales. CONCLUSION: The adapted MSPSS can reliably be used in Uganda.