Correlates of depression among internally displaced persons after post-election violence in Kaduna, North Western Nigeria.

BACKGROUND: In April 2011, a post-election violent conflict in northern Nigeria led to resettlement of internally displaced persons (IDPs) in a camp in Kaduna, the worst affected state. We set out to determine the prevalence of depression among the IDPs. We also determined socio-demographic and other correlates of depression among the IDPs. METHODS: Cross-sectional systematic random sampling was used to select 258 adults IDPs. We used the Hopkins symptom checklist to diagnose probable depression, composite international diagnostic interview for diagnosis of definite depression and communal trauma event inventory to determine exposure to psycho-trauma. We assessed social adjustment using social provision scale and Harvard trauma questionnaire to diagnose "symptomatic PTSD". Multiple logistic regression was used to determine independent predictors of depression. RESULTS: Of the 258 IDPs, 154 (59.7%) had probable depression, and 42 (16.3%) had definite depression. Females were more likely to have probable depression (1.68, 95% CI 1.02-2.78; p=0.04) and definite depression (2.69, 1.31-5.54; p= 0.006). IDPs with co-morbid PTSD were more likely to have probable depression (16.9, 8.15-35.13; p<0.000) and definite depression (3.79,1.86-7.71; p<0.000). A comorbid CIDI diagnosis of PTSD (AOR 16.6, 7.2-38.6; p<0.000) and psycho-trauma of getting beaten (AOR 2.7, 1.1-6.7; p=0.004) remained as independent predictors of probable depression among the IDPs. The male gender remained a protective factor against probable depression (AOR 0.3, 0.1-0.7; p= 0.006). LIMITATIONS: This study was conducted 2 years post-conflict and only IDPs living in the camps were studied. CONCLUSION: IDPs living in Hajj camp in Kaduna, northern Nigeria developed post-conflict probable depression and definite depression. Female gender, experienced beating and comorbid diagnosis of PTSD were independent predictors of probable depression among the IDPs, while IDPs that were unemployed or retired had more of definitive depression.

Psycho-Trauma, Psychosocial Adjustment, and Symptomatic Post-Traumatic Stress Disorder among Internally Displaced Persons in Kaduna, Northwestern Nigeria.

BACKGROUND: In April 2011, a post election violent conflict in Northern Nigeria led to resettlement of internally displaced persons (IDPs) in a camp in Kaduna, the worst affected state. We set out to determine prevalence and socio-demographic factors associated with post-traumatic stress disorder (PTSD) among IDPs. We also determined types of psycho-trauma experienced by the IDPs and their psychosocial adjustment. METHODS: Cross-sectional systematic random sampling was used to select 258 adults IDPs. We used Harvard trauma questionnaire to diagnose "symptomatic PTSD," composite international diagnostic interview (CIDI) for diagnosis of depression, and communal trauma event inventory to determine exposure to psycho-trauma. We assessed social adjustment using social provision scale. Multiple logistic regression analysis was used to determine independent predictors of PTSD. RESULTS: Of the 258 IDPs, 109 (42.2%) had a diagnosis of PTSD, 204 (79.1%) had poor living conditions, and only 12 (4.7%) had poor social provision. The most frequent psycho-traumas were destruction of personal property (96.1%), been evacuated from their town (96%) and witnessing violence (88%). More than half (58%) of IDPs had experienced 11-15 of the 19 traumatic events. Independent predictors of PTSD among respondents were having a CIDI diagnosis of depression (adjusted odds ratios 3.5, 95% confidence interval 1.7-7.5; p = 0.001) and witnessing death of a family member (3.7, 1.2-11.5; p = 0.0259). CONCLUSION: We concluded that exposure to psycho-trauma among IDPs in Kaduna led to post conflict PTSD. Death of a family member and co-morbid depression were independent predictors of PTSD among IDPs. Though their living condition was poor, the IDPs had good psychosocial adjustment. We recommended a structured psychosocial intervention among the IDP targeted at improving living condition and dealing with the psychological consequences of psycho-trauma.

Unrecognized psychiatric disorders among adult patients admitted into a general hospital in Maiduguri, Northeastern Nigeria.

INTRODUCTION: Patients with unrecognized psychiatric disorders in general hospitals, suffer economic and psycho-social difficulties. This study aimed to determine (i) prevalence and pattern of psychiatric disorders, and (ii) prevalence of unrecognized psychiatric disorders among adult in-patients of a general hospital. METHODS: In this two-stage, cross-sectional study, we used (i) General Health Questionnaire (GHQ) and Composite International Diagnostic Interview (CIDI) to assess the prevalence of psychiatric disorders, and (ii) Patient Encounter Form to determine unrecognized psychiatric disorders, among patients admitted into a general hospital. RESULTS: Of the 283 respondents, 174 (61.5%) had GHQ scores of ≤ 4. Eighty seven respondents (31%) had psychiatric disorders of which 85 (98%) were not recognized. The frequency of Depression and Anxiety disorders were 61.5% and 26.2% respectively. Unmarried (2.3, 1.2-4.3; p < 0.00), females (2.1, 1.1-4.05; p = 0.01) and patients with "unexplained symptoms" (≤ = 8.4, p< 0.00, df = 1) were more likely to have diagnosis of depression and anxiety disorder. CONCLUSION: We conclude that one-third of the patients in the general hospital, had co-morbid psychiatric diagnoses, mostly unrecognized by their physicians. Unmarried, females and respondents with unexplained symptoms were associated with depression and anxiety disorders. We recommend the posting of psychiatric trainees to general hospitals, and training of general practitioners on the use of simple depression and anxiety screening instruments.