The perception of family function by adolescents with epilepsy in a rural nigerian community.

The family plays a significant role in epilepsy management in sub-Saharan Africa and how this role is perceived by persons with epilepsy could influence epilepsy outcomes. The objective of the study was to assess perception of family function by adolescents with epilepsy (AWE). The sociodemographic and epilepsy characteristics of AWE in a rural Nigerian community were assessed and the Family APGAR tool was used in assessing their perception of satisfaction with family functioning. Adolescents (n = 1708) constituted 26% of the community's population and 18 (10.5/1000) had epilepsy. The AWE age range was 11-19 years (mean 16.7 ± 2.6 years) with a male preponderance (15, 83.3%). The family was the only source of care. Family dysfunction (Family APGAR Score <7) was indicated by 15 (83.3%) of the AWE. The strongest perception of family function was in adaptability while the weakest was with growth. The indication of family dysfunction was significant (P<0.05) in the older (age 14-19 years) AWE when compared with the younger AWE (11-13 years) in the study. Most of the AWE indicated living in a dysfunctional family setting. The study highlights the need to address the role of the family in the provision of comprehensive epilepsy care.

Validation of short screening tools for common mental disorders in Nigerian general practices.

OBJECTIVE: The objective was to examine the psychometric properties of two brief screening questionnaires for common mental disorders in general practices in areas speaking the three main Nigerian languages. METHOD: Consecutives attendees of selected general practices in Ibadan, Enugu and Kaduna were screened with the General Health Questionnaire 12-item version (GHQ12) and K6. We selected all cases and 50% of noncases for second-stage interview with the Composite International Diagnostic Interview. The receiver operating characteristic curves were generated for both questionnaires, and optimal cutoffs were determined. Exploratory factor analysis was done for both questionnaires. RESULTS: The K6 had an area under the curve (AUC) of 0.62 for depression and 0.58 for anxiety disorder. The GHQ12 had an AUC of 0.74 for depression, while that for generalized anxiety disorder was 0.6. The GHQ12 was able to correctly classify 75% of the subjects with or without depression, while the K6 was able to correctly classify 56% of the subjects with or without depression. The optimal cutoff for both questionnaires was 4, selecting the point of best balance of sensitivity and specificity. CONCLUSION: The findings suggest that the GHQ12 will be a useful tool in screening for common mental disorders in general practice in Nigeria.

Social consequences of epilepsy: a study of 231 Nigerian patients.

BACKGROUND: Epilepsy is the commonest neurological disorder and majority of the sufferers are found in the developing countries. It is associated with psychological and social problems. The aim of this study was to determine the social difficulties experienced by epileptic patients and the factors that are associated with these difficulties. METHODS: Two hundred and thirty-one consecutive epileptic patients who were of age 10 years and above, and who had no co-morbid major psychiatric disorder, seen over a 6-month period at the outpatient clinic of Federal Neuro-psychiatric Hospital, Kaduna, were interviewed. We used an instrument designed for the purpose of this study, which focused on people's attitudes to epilepsy, relationship/marital, employment and academic problems. RESULTS: The mean age of the subjects was 28 +/- 13.2 years; 59.3% were males; 44.6% said people make negative remarks about their illness; 14.1% have been denied leadership role; 36.4% were irregular at work; 37.3% performed poorly at work; 22.5% have had their marriage proposals rejected; 19.5% have been abandoned by spouse. At least 39.4% had poor academic performance while 19.5% were withdrawn from school because of epilepsy. Short seizure-free period, long duration of seizure disorder and family history of epilepsy were significantly associated with social problems. CONCLUSION: Social difficulties are common among epileptics. Effort should be made to educate the society about epilepsy, and physicians treating patients with epilepsy should aim at achieving a good seizure control.