First Episode Psychosis during COVID-19 Pandemic: A Case Series.

INTRODUCTION: Neuropsychiatric events are often associated with viral pandemics. The unexpected turn of events the world over since the onset of the coronavirus pandemic may serve as stressors which can trigger or worsen mental disorders particularly psychosis. There is little or no reports about acute psychosis on the background of this current global pandemic particularly in the African context. The aim of this article describes a case series of acute schizophrenia-like disorder with COVID-19 related psychotic themes in the context of the current pandemic. MATERIALS AND METHODS: We present a case series of 2 patients with first episode psychotic illnesses during the COVID-19 pandemic. Both patients presented at the mental health outpatient clinic of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. RESULTS: Two patients with no previous history of mental illness presented with COVID-19 delusional themes and odd behaviours. Mental state examination revealed abnormalities in behaviour, thought system, perception and cognition. ICD10 diagnosis of Acute and Transient Psychotic disorder was made in both patients. There were no abnormal physical health findings and symptoms resolved with the use of antipsychotics. CONCLUSION: Information on the COVID-19 pandemic may influence the content of psychotic experiences among the general population. A high index of suspicion and acute services are important to ensure prompt intervention and promotion of community mental health. Clinicians need to be well informed to be able to identify what deviates from the norm, and to be able to provide prompt intervention.

INTRODUCTION: Les événements neuropsychiatriques sont souvent associés aux pandémies virales. La tournure inattendue des événements dans le monde depuis le début de la pandémie de coronavirus peut servir de facteurs de stress pouvant déclencher ou aggraver des troubles mentaux, en particulier la psychose. Il y a peu ou pas de rapports sur la psychose aiguë sur le fond de cette pandémie mondiale actuelle en particulier dans le contexte africain. Le but de cet article décrit une série de cas de troubles de type schizophrénique aigu avec des thèmes psychotiques liés au COVID-19 dans le contexte de la pandémie actuelle. MATÉRIELS ET MÉTHODES: Nous présentons une série de cas de 2 patients présentant un premier épisode de maladie psychotique pendant la pandémie de COVID-19. Les deux patients se sont présentés à la clinique externe de santé mentale du complexe hospitalier universitaire Obafemi Awolowo, à Ile-Ife, au Nigéria. RÉSULTATS: Deux patients sans antécédents de maladie mentale ont présenté des thèmes délirants et des comportements étranges liés à la COVID-19. L'examen de l'état mental a révélé des anomalies dans le comportement, le système de pensée, la perception et la cognition. Le diagnostic ICD10 de trouble psychotique aigu et transitoire a été posé chez les deux patients. Il n'y a eu aucun signe anormal de santé physique et aucun symptôme n'a été résolu avec l'utilisation d'antipsychotiques. CONCLUSION: Les informations sur la pandémie de COVID-19 peuvent influencer le contenu des expériences psychotiques au sein de la population générale. Un indice élevé de suspicion et des services aigus sont importants pour assurer une intervention rapide et la promotion de la santé mentale communautaire. Les cliniciens doivent être bien informés pour pouvoir identifier ce qui s'écarte de la norme et pouvoir intervenir rapidement. MOTS-CLÉS: COVID-19, psychose aiguë et transitoire, pandémie, premier épisode de psychose, facteurs de stress.

Economic Cost of Asthma and Psychiatric Morbidity in Nigerian Patients with Asthma.

BACKGROUND: Asthma is known to constitute a huge economic burden to its sufferers and their carers. There is a dearth of studies documenting this burden among asthmatics in Nigeria. OBJECTIVE: This study assessed the relationship between economic cost and psychiatric morbidity among stable Nigerian patients with asthma. METHODS: 85 patients with asthma completed a socio-demographic and illness-related questionnaire, the modified Economic Cost Questionnaire and General Health Questionnaire 12 (GHQ 12). Associations between socio-demographic characteristics, illness related variables, psychiatric morbidity and the direct, indirect and total costs in relation to asthma were assessed. RESULTS: The average annual total, direct and indirect cost were $309, $190.65 and $118.34 respectively per patient for subjects with asthma. Direct cost constituted 62.7% while the indirect cost was 38.3% of the total cost for asthma. Drugs and hospitalisation were leading contributors to direct costs for asthma. Psychiatric morbidity was found to be present in 35% of subjects with asthma, those with psychiatric morbidity had a higher economic burden. CONCLUSION: The economic cost of asthma is high, psychiatric morbidity increases this cost. The cost is largely due to drugs and hospitalisations for exacerbation. There is an urgent need to optimize means of helping to minimize this cost and increase measures for detecting and treating psychiatric morbidity.

Relationship between depressive symptoms and quality of life in Nigerian patients with schizophrenia.

PURPOSE: Quality of life (QOL) in patients with schizophrenia is influenced by various factors such as depressive symptoms. This study assessed the relationship between depressive symptoms and QOL in outpatients with schizophrenia in Nigeria and evaluated the associated socio-demographic and clinical factors. METHODS: One hundred patients with 10th edition of the International Classification of Diseases diagnosis of schizophrenia participated in this study. Socio-demographic and clinical factors such as depression were assessed with Zung Self-rating Depression Scale and symptoms of schizophrenia with the Positive and Negative Syndrome Scale of schizophrenia (PANSS). The level of functioning was assessed with the Global Assessment of Functioning Scale. QOL was assessed using the brief version of the World Health Organisation Quality of Life Scale. RESULTS: There were 27 (27.0 %) patients with depression. The depressed patients reported significant lower scores in all QOL domains when compared with the non-depressed group. All QOL domains were significantly negatively correlated with the total PANSS and all its subscales (except for psychological domain with total PANSS and social relationship and environmental domains with PANSS positive). Severity of depressive symptoms was significantly negatively correlated with all QOL domains. Functioning was significantly positively correlated with all QOL domains except in the environmental domain. Multiple regression analysis showed that depressive symptoms predicted all QOL domains except the social relationship domain while negative symptoms predicted social relationship and environmental domains. CONCLUSION: Depression is a common occurrence during the course of schizophrenia. Depressive and negative symptoms have a significant impact on the QOL of patients with schizophrenia.