Prevalence and Correlates of Suicidal Ideation among Medical Students in a Tertiary Institution in Southern Nigeria.

INTRODUCTION: Medical students have an increased risk of suicidal ideation compared to similar age groups within the general population. Suicidal ideation is a significant predictor of suicidal attempt, therefore, identifying and addressing factors associated with suicidal ideation among medical students may potentially reduce their overall rates of suicide. AIM: To determine the prevalence and correlates of suicidal ideation among medical students in a Nigerian medical school. METHODOLOGY: This was a cross-sectional study that determined the prevalence and correlates of suicidal ideation among clinical students. Beck's suicidal ideation questionnaire, Beck's depression inventory and World Health Organisation Alcohol Smoking and Substance Involvement Screening Test (ASSIST) were used to assess for suicidal ideation, depression and lifetime substance use respectively. P value of <0.05 was taken as significant. METHODOLOGY: This was a cross-sectional study that determined the prevalence and correlates of suicidal ideation among clinical students. Beck's suicidal ideation questionnaire, Beck's depression inventory and World Health Organisation Alcohol Smoking and Substance Involvement Screening Test (ASSIST) were used to assess for suicidal ideation, depression and lifetime substance use respectively. P value of <0.05 was taken as significant. RESULTS: One hundred and twenty-one students participated in the study. Mean age of the participants was 21.78±3.54 years. The prevalence of suicidal ideation was 12.4%. Factors associated with suicidal ideation were intimate relationship problems (p=0.03); being managed for a chronic medical condition (p=0.02); higher depression scores (p<0.001); and having fewer maternal siblings (p=0.02). Forty-five (37.2%) students had a life time use of psychoactive substances which was mainly alcohol. CONCLUSION: Suicidal ideation was relatively high among the medical students. Medical schools should create programmes that will cater for the emotional and psychological wellbeing of their students to reduce their suicidal risk.

INTRODUCTION: Les étudiants en médecine ont un risque accru deles idées suicidaires par rapport à des groupes d'âge similaires au sein de l'population générale. Les idées suicidaires sont un prédicteur important de tentatives de suicide, par conséquent, identifier et traiter les facteurs associés à des idées suicidaires chez les étudiants en médecine peuvent réduire potentiellement leur taux global de suicide. OBJECTIF: Déterminer la prévalence et les corrélats des suicides idéation parmi les étudiants en médecine dans une école de médecine nigériane. MÉTHODOLOGIE: Il s'agissait d'une étude transversale qui déterminé la prévalence et les corrélats des idées suicidaires parmi les étudiants cliniciens. Le questionnaire d'idées suicidaires de Beck,L'inventaire de la dépression de Beck et l'Organisation mondiale de la santéTest de dépistage du tabagisme et de la toxicomanie(ASSIST) ont été utilisés pour évaluer les idées suicidaires, la dépression et la consommation de substances au cours de la vie, respectivement. La valeur P de <0,05 était considérés comme significatifs. RÉSULTATS: Cent vingt et un étudiants y ont participédans l'étude. L'âge moyen des participants était de 21,78 ±3,54 ans.La prévalence des idées suicidaires était de 12,4 %. Facteurs associés à des idées suicidaires étaient une relation intime problèmes (p = 0,03); être pris en charge pour un traitement médical chroniquecondition (p = 0,02); scores de dépression plus élevés (p<0,001); etavoir moins de frères et sœurs maternels (p = 0,02). Quarante-cinq (37,2 %)les élèves ont consommé toute leur vie des substances psychoactives qui était principalement de l'alcool. CONCLUSION: Les idées suicidaires étaient relativement élevées chez les étudiants en médecine. Les facultés de médecine devraient créer des programmes qui répondront aux besoins émotionnels et psychologiquesle bien-être de leurs élèves pour réduire leur risque suicidaire. Mots-clés: Idées suicidaires, étudiants en médecine, Nigéria.

Attitudes towards and rationale for antipsychotic polypharmacy among psychiatrists in Nigeria: Characteristics associated with high reported antipsychotic polypharmacy.

Antipsychotic polypharmacy (APP) is commonplace despite lacking evidence of its effectiveness. We aimed to identify psychiatrists' rationale for and attitudes towards APP and to determine if attitudes influence antipsychotic polypharmacy prescription rates in a survey of a nationally representative sample of Nigerian psychiatrists (of which a majority were senior trainees: 74.2%). Prescriber characteristics, practices and attitudes were compared in 'high' (>30%) vs. 'low' (≤30%) antipsychotic polypharmacy prescribers and results were adjusted for multiple comparisons. Altogether, prescribers reported utilizing antipsychotic polypharmacy in 36.2% of their patients. Compared to 'low' antipsychotic polypharmacy prescribers, 'high' prescribers were significantly more likely using first-generation antipsychotics (FGA) combination, to have attempted a switch to monotherapy in less patients, or been successful in doing so. 'High' and 'low' antipsychotic polypharmacy prescribers were equally moderately concerned about the effects of antipsychotic polypharmacy and also did not differ regarding reasons not justifying antipsychotic polypharmacy. In a multivariable, backward elimination logistic regression model, 'low' antipsychotic polypharmacy was associated with having successfully switched patients to monotherapy, whereas the 'high' antipsychotic polypharmacy was associated with preferring FGA+FGA combinations and aiming for a reduction of non-antipsychotic medications. Antipsychotic polypharmacy is common among psychiatrists in Nigeria, with 'high' and 'low' antipsychotic polypharmacy prescribers sharing similar concerns/attitudes, but differing regarding their primary aim for antipsychotic polypharmacy and in their specific antipsychotic polypharmacy use characteristics.

The attitudes of clergy in Benin City, Nigeria towards persons with mental illness.

OBJECTIVE: The clergy in sub-Saharan Africa play a major role in the care and pathways to orthodox mental health services of the mentally ill. Their attitudes concerning mental illnesses would influence community mental health intervention efforts. This study aimed to determine the attitudes of clergy towards persons with mental illness. METHOD: A cross-sectional survey of clergy (n = 107) of the Christian and Muslim faiths was conducted, using a socio-demographic questionnaire and the 40- item Community Attitudes towards Mental Illness (CAMI) scale. RESULTS: Stigmatizing attitudes were evident among members of the clergy surveyed. Most (71.1%) believed the mentally ill were different from other persons, while 68.2% were of the opinion that the mentally ill should be controlled like children. Over 80% of respondents were not comfortable with the idea of the mentally ill living in their vicinity and wanted mental health hospitals situated out of residential areas. Almost half of respondents (45.8%) were uncomfortable with women who were once mentally ill baby-sitting and 63.2% agreed that our mental hospitals seem more like prisons than where the mentally ill can be cared for. CONCLUSION: Negative attitudes towards the mentally ill were widespread among the clergy sampled. Mental health professionals need to take proactive steps to improve the mental health knowledge of the clergy which may facilitate their roles in the pathway to mental health care.

Clinical Anxiety among Final Year Dental Students: The Trainers and Students Perspectives

Background: The dental clinical setting; which is a significant learning environment for undergraduate dental students; may induce anxiety; which may adversely affect the clinical performance. The purpose of this cross-sectional study was to determine the factors provoking clinical anxiety in dental students from the trainers and students perspectives. Materials and Methods: This cross-sectional study was conducted among 6 th (final) year dental students of University of Benin and their clinical trainers between January and March 2012 using the 38-item modified Moss and McManus clinical anxiety questionnaire. Results: Of the 67 participants; 32 (47.8) were 6 th year dental students while 35 (52.2) were clinical trainers. According to the students; the top clinical anxiety provoking situations were inability to meet requirements before exams; inability to pass the final exams; dealing with psychiatric patients; coping with uncooperative children; getting infected by patients; fracturing a tooth during extraction; extracting the wrong tooth; discovering calculus by the supervisor after scaling; accidental pulp exposure; inadvertently hurting patients and using the high speed hand piece. There existed concordance on the top two clinical anxiety provoking situations reported by the students and their clinical trainers. However; measuring blood pressure; taking pulse; presenting in the clinic; handling a syncopal attack; and accidental pulp exposure were statistically significant contrasting clinical anxiety provoking situations from dental students and trainers perspectives. Conclusion: Data from this study revealed that clinical trainers share largely the same perspectives with the dental students on the clinical anxiety provoking situations with slight variations. Fostering a supportive learning environment conducive to dental student learning by strengthen efforts to minimize clinical anxiety is a necessity

Oral health of psychiatric patients: the nurse's perspective.

OBJECTIVE: To assess nurses' perspectives on character, prevalence and cause of oral diseases among psychiatric patients and also their approach and suggestions in relation to the care of oral problems. MATERIALS AND METHODS: A questionnaire-based cross-sectional survey of all cadres of nurses (n = 136) at the Federal Psychiatric Hospital, Benin City, Nigeria, was conducted between December 2010 and January 2011. RESULTS: Two-thirds (67.6%) of the respondents reported that psychiatric in-patients in comparison with the general population have a higher occurrence of oral and dental problems. Commonly cited reasons for the poor oral health of patients included as follows: sedation for long periods, lack of care by family, psychopathological symptoms, poor access to dentists and lack of oral hygiene advice. The common oral health complaints received by the respondents included toothache, pain from the gums and inability to open the mouth. Majority (91.4%) of respondents claimed to be presently involved with oral care of psychiatric in-patients but oral care delivery is however bedevilled with lot of barriers like uncooperativeness of patients and lack of oral care materials. CONCLUSION: Oral complaints received are frequent and numerate with limited palliative action rendered. Attaching dentists to psychiatric hospitals and regular training of psychiatric nurses on oral care delivery are recommended to comprehensively cater for the oral health problems of psychiatric in-patients.

Electroconvulsive therapy: a comparison of knowledge and attitudes of student nurses and staff mental health nurses at a psychiatric hospital in Nigeria.

Electroconvulsive therapy (ECT) is effective in the treatment of some psychiatric disorders. Among other reasons, service users may refuse ECT when indicated due to myth and little or lack of knowledge about the procedure. The knowledge of and attitude towards ECT among nurses may reflect on patients and influence treatment choice. Previous studies, conducted in developed countries have explored knowledge and attitudes towards ECT among nurses, but none have been conducted in this part of the world. The following article compares the knowledge of and attitude towards ECT among student and staff mental health nurses at a psychiatric hospital in Nigeria. A cross sectional survey of 135 student nurses and staff mental health nurses showed that knowledge and attitude scores were more positive among staff mental health nurses compared with student mental health nurses. Additional years of experience correlated with better knowledge and positive attitudes among staff mental health nurses. Overall, the majority of the respondents felt that ECT was beneficial to patients, was overused and required guidelines for its practice in this country.