Depression and suicidality among adolescents living with human immunodeficiency virus in Lagos, Nigeria.

BACKGROUND: Nigeria is considered to have the second highest number of people living with human immunodeficiency virus (HIV) worldwide with a national HIV infection prevalence of 5.2% in children and adolescents. Adolescents with HIV-infection have been reported to be more prone to developing comorbid emotional difficulties including depression and suicidality compared to those without HIV-infection. This study is aimed at determining the prevalence and correlates of depression and suicidality in adolescents living with HIV infection. METHODS: Through a consecutive sampling method, two hundred and one adolescents attending HIV outpatient clinics in two tertiary hospital (Lagos state University Teaching Hospital and Nigerian Institute of Medical Research) were recruited. Confidentiality was assured and maintained. Suicidality and Depression were assessed with their corresponding modules in Mini International Neuropsychiatric Interview for children and adolescents (MINI-Kid) by researcher, while the independent variables were assessed using self-administered questionnaires. Data was analyzed with Statistical Package for Social Science version 20. RESULT: The prevalence of current and lifetime major depressive episode, and suicidality were 16.9%, 44.8% and 35.3% respectively. Female gender, decreased cluster of differentiation 4 (CD4) count and high adverse childhood experience (ACE), were significantly associated with current depressive episode, while poor social support, high ACE, physical abuse, contacting HIV infection after birth and disclosure of status, were associated with lifetime major depressive episode. Factors associated with suicidality were high ACE score, physical abuse, and emotional abuse. After logistic regression analysis; gender, high ACE and CD4 level were independently associated with current major depression, while only poor social support and contracting HIV infection after birth, were independently associated with lifetime major depression. There was a positive correlation between suicidality and depression. CONCLUSION: The presence of high rate of depression and suicidality among adolescents living with HIV-infection in the current study clearly shows the need for regular psychological assessment in these group of adolescents, and thus a strong indication for a multidisciplinary management in them.

The relationship between coping styles and depression among caregivers of children with cerebral palsy in Nigeria, West Africa

Abstract Background Caring for a child with cerebral palsy (CP) is an arduous task and the over-reliance on specific coping strategies may predispose caregivers to depression. Objective The aim of this study was to determine the relationship between the different types of coping strategies and presence of depression in caregivers of children with CP. Methods One hundred and thirty two participants were recruited into the study. Their coping styles were measured using the Brief COPE inventory while depression was assessed with Mini International Neuropsychiatric Interview. Results The prevalence of current depressive episodes among the participants was 20.5%. Depression had a strong negative correlation with active coping (r = -0.415), planning (r = -0.432), and positive reframing (r = -0.594), and a weak negative correlation with humor (r = -0.239). But a strong positive correlation with use of instrumental support (r = 0.421) and self-blame (r = 0.448), and a moderate positive correlation with denial (r = 0.313), and behavioral disengagement (r = 0.308). Both emotion-focused (r = -0.361) and problem-focused (r = -0.576) coping style had a strong negative correlation with depression. While dysfunctional coping style had a strong positive correlation with depression (r = 0.489). Discussion Emotional and problem focused coping style were found to more protective against depression than dysfunctional coping styles among care givers of children with CP.

Gender and obstetric factors in the determination of the age of onset of schizophrenia in a Nigerian cohort.

The importance of gender and obstetric factors as predictors of the age of onset of schizophrenia is debatable. Unfortunately, there is a significant dearth of studies in developing countries such as Nigeria. This study involved a survey of patients with schizophrenia (n = 1,445; N = 2,393), from March 2014 to March 2016, from a psychiatric hospital in southwest Nigeria. Structured diagnostic interviews were used to confirm diagnosis. Females had a higher age of onset (M = 34.91, SD = 15.52) compared with males (M = 28.78, SD = 10.62; p = .00, M = 32.74 ± 12.96). Gender and marital status were the only variables significantly related to the age of onset (p = .00). Our model predicted 10.1% of the variability in the determination of the age of onset of schizophrenia. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Development and feasibility assessment of a collaborative stepped care intervention for management of depression in the mental health in primary care (MeHPriC) project, Lagos, Nigeria.

BACKGROUND: This study aimed to develop and test the feasibility of a primary care worker-led psychological intervention as the main feature of a collaborative stepped care for depression that is effective, affordable, culturally acceptable, tailored to patients' clinical condition and easily integrate-able into the primary care schedule in Nigeria. METHODS: Using the Medical Research Council framework, in the first stage (modelling/theoretical development), experts reviewed and distilled evidence from literature to form the intervention components. In the second (formative) stage, local stakeholders were consulted on the practical application and feasibility of the proposed intervention. The third (piloting) stage involved testing for the clinical efficacy and acceptability of the components of the draft intervention. RESULTS: The final intervention components included a 2-stage screening (red-flagging and further evaluation), psychoeducation, low-intensity psychological therapy (problem-solving therapy for primary care), antidepressant prescription, proactive mobile telephony adherence support and referral to the mental health specialist if needed. At 3 months, 71.6% of depressed patients on the intervention improved. The intervention was perceived to be acceptable and useful by over 70% of health workers and clients and had high ratings (>70% score) by expert panels on intervention simplicity, facilitation strategies, and quality of delivery. CONCLUSIONS: The development and feasibility testing of our integrated intervention encompassed review of current literature, expert opinions and consultation with local stakeholders and end users. Our intervention package was largely deemed acceptable, relevant, useful, and feasible. Important lessons learnt with this process will help in future intervention developments.