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 18­59 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 18­63 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

Fatores de risco de apneia obstrutiva do sono entre pacientes ambulatoriais nigerianos / Risk factors of obstructive sleep apnea among nigerian outpatients

Apneia obstrutiva do sono (SAOS) é uma condição médica com consequências adversas. OBJETIVOS: Descrever os fatores de risco associados com OSA em adultos atendidos em uma clínica especializada ambulatorial. Forma de estudo: Estudo clínico prospectivo, entre pacientes ambulatoriais adultos em uma clínica especializada. MÉTODO: Os dados foram coletados por meio de questionário incorporando o BQ e os pacientes foram divididos em riscos de baixa e alta da OSA. Os fatores de risco associados com OSA na análise univariada foram submetidas a um modelo multivariado de regressão logística binária. Odds ratio ajustados com intervalo de confiança de 95% foram calculados para as seguintes variáveis independentes. RESULTADOS: Cento e nove e cinco pacientes participaram do estudo (sexo masculino 56,4%; idade 43,5 ± 15,6 anos; não roncadores habituais 81,5%, risco de alta OSA 17,4%, IMC 24,1 ± 4,6 kg/m²; obesos 12,9%). Seis fatores, incluindo o estado civil e a pressão arterial, foram significativamente associados com SAOS usando análise bivariada, no entanto, idade, horas de trabalho, tabagismo e IMC permaneceu preditivo da OSA na análise de regressão logística. CONCLUSÕES: SAOS é comum entre pacientes nigerianos, pode ser sub-reconhecida e está associada a fatores de risco que são passíveis de estratégias preventivas.

Obstructive sleep apnea (OSA) is a medical condition with adverse consequences. OSA is credited to be a sleep disorder that disproportionately affects blacks. The Berlin Questionnaire (BQ) is a screening questionnaire for OSA. OBJECTIVE: To describe the risk factors associated with OSA among adults attending an out-patient specialist clinic. Study design: Prospective, clinical study including adult outpatients attending a specialist clinic. METHOD: Data was collected using a questionnaire incorporating the BQ and patients were divided into low and high risks of OSA. The risk factors associated with OSA in the univariate analyses were subjected to a multivariate binary logistic regression model. Adjusted odds ratios with 95% confidence intervals were calculated for these independent variables. RESULTS: One hundred and ninety five patients participated in the study (Males 56.4%; Age 43.5 ± 15.6 years; Non-habitual snorers 81.5%; High risk OSA 17.4%; BMI 24.1 ± 4.6 kg/m²; Obese 12.9%). Six factors including marital status and blood pressure were significantly associated with OSA using bivariate analysis nevertheless age, hours at work, smoking status and BMI remained predictive of OSA on logistic regression analysis. CONCLUSIONS: OSA is common among Nigerian outpatients, may be under-recognized and is associated with risk factors that are amenable to preventive strategies.