Prevalence, Factors, and Outcome of Physical Violence against Mental Health Professionals at a Nigerian Psychiatric Hospital.

OBJECTIVES: This cross-sectional study aimed to assess the prevalence, factors, and consequences of physical violence by mentally ill patients against mental health professionals. METHODS: 124 of 145 mental health professionals at a Nigerian neuropsychiatric hospital satisfactorily completed a questionnaire on their experiences with physical assault. RESULTS: 77 (62.1%) staff had been assaulted during their whole career; 38 (30.6%) of them were assaulted in the past 12 months. The most common type of assault was pushing (32.9%). The most common antecedent event to assault was calming an aggressive patient (44.1%). In their whole career, 22.1% of assaulted staff sustained injuries that required medical attention; 42.4% of assaulted staff sometimes or frequently/always experienced posttraumatic stress disorder symptoms. Physical assault in the whole career was associated with older age (p = 0.04), longer years of practice (p = 0.01), and job dissatisfaction (p = 0.05). CONCLUSIONS: Physical violence encountered by mental health professionals at a Nigerian neuropsychiatric hospital is substantial. Policy review of staff safety, training, and support is recommended.

Depression among people living with human immunodeficiency virus infection/acquired immunodeficiency syndrome in Benin City, Nigeria: a comparative study.

BACKGROUND: Depression is a common co-morbidity among persons living with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) (PLWHAs). It is associated with poor treatment adherence and higher mortality rates. Few reports have, however, emanated from developing countries where socioeconomic factors may confound this association. MATERIALS AND METHODS: We conducted a cross-sectional comparative study of PLWHAs and apparently healthy staff of three LGA's. The depression module of the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN) and the Beck Depression Inventory (BDI) was used to diagnose depression and depression symptom severity, respectively. RESULTS: Depression was commonly co-morbid among individuals with HIV/AIDS. It was five times more common in PLWHAs than in apparently healthy populations (29.3% vs. 7.3%, OR: 5.25, 95% CI: 2.50-11.76). A similar trend was observed for depression symptom severity. Among PLWHAs, depression was significantly more likely among females (OR: 7.91, 95% CI: 1.83-71.00, P < 0.01), those unemployed (OR: 2.94, 95% CI: 0.18-1.82, P < 0.04), and with an illness duration >3 years (OR: 7.90, P < 0.0001). Having at least one child (OR: 2.79, 95% CI: 1.25-6.16, P < 0.001) and living with others (OR: 4.71, 95% CI: 1.51-15.52, P < 0.003) significantly reduced depression risk. CONCLUSION: Depression was commonly co-morbid among PLWHAs studied. Clinicians should be aware of risk factors for depression among PLWHAs in order to improve treatment outcomes.

Depression among People Living with Human Immunodeficiency Virus Infection/Acquired Immunodeficiency Syndrome in Benin City; Nigeria: A comparative Study

Background: Depression is a common co-morbidity among persons living with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) (PLWHAs). It is associated with poor treatment adherence and higher mortality rates. Few reports have; however; emanated from developing countries where socioeconomic factors may confound this association. Materials and Methods: We conducted a cross-sectional comparative study of PLWHAs and apparently healthy staff of three LGA's. The depression module of the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN) and the Beck Depression Inventory (BDI) was used to diagnose depression and depression symptom severity; respectively. Results: Depression was commonly co-morbid among individuals with HIV/AIDS. It was five times more common in PLWHAs than in apparently healthy populations (29.3vs. 7.3; OR: 5.25; 95 CI: 2.50-11.76). A similar trend was observed for depression symptom severity. Among PLWHAs; depression was significantly more likely among females (OR: 7.91; 95 CI: 1.83-71.00; P 0.01); those unemployed (OR: 2.94; 95CI: 0.18-1.82; P 0.04); and with an illness duration 3 years (OR: 7.90; P 0.0001). Having at least one child (OR: 2.79; 95 CI: 1.25-6.16; P 0.001) and living with others (OR: 4.71; 95 CI: 1.51-15.52; P 0.003) significantly reduced depression risk. Conclusion: Depression was commonly co-morbid among PLWHAs studied. Clinicians should be aware of risk factors for depression among PLWHAs in order to improve treatment outcomes

Suicidality among individuals with HIV/AIDS in Benin City, Nigeria: a case-control study.

Suicidality has been reported to be common in persons living with HIV/AIDS (PLWHA). Reports from sub-Saharan countries have been scanty. We surveyed the prevalence of suicidal ideation and attempt among PLWHAs (n=150) and compared them with staff of a local government who acted as controls. Over a third (34.7%) of PLWHAs versus 4% of controls expressed suicidal ideation in the preceding month, with 9.3% attempting suicide in the six months prior to the study. Commonest type of attempt was a drug overdose. Female gender, unemployment, co-morbid illness, living alone and having a partner with the disease were associated with suicidal ideation. Clinicians should routinely enquire about suicidality in PLWHAs to reduce mortality.

Co-morbid psychiatric disorders in Nigerian patients suffering temporomandibular joint pain and dysfunction.

OBJECTIVES: To determine the prevalence of psychiatric morbidity among Nigerian patients with temporomandibular joint pain and dysfunction (facial arthromyalgia). to delineate the specific types of comorbid psychiatric disorders and identify the socio-demographic characteristics of the patients with psychiatric disorders. DESIGN: A two-stage design was adopted to study the prevalence and types of co-morbid psychiatric disorders of identified 24 patients with temporomandibular joint pain and dysfunction over a period of 5 years. SETTING: Pain and Psychiatric clinics of the University of Benin Teaching Hospital, Benini City, Nigeria. METHODS: The patients were controlled for age gender, and marital status. The State-Trait Anxiety Inventory. 28-item General Health Questionnaires and the Hospital Anxiety and Depression Scales were used for first stage screening while the second stage interview utilised the Psychiatric Assessment Schedule. RESULTS: The prevalence of psychiatric morbidity was 37.5% and 12.5% in the study and control groups respectively. Generalised anxiety disorder and dysthmia were the main forms of psychiatric disorders identified. Temporomandibular joint pain and dysfunction patients with co-morbid psychiatric disorders were significantly older (P<0.0001), had the illness for shorter periods before presentation (p<0.001) and were non-professionals. CONCLUSION: The findings highlight the need for multi-disciplinary approach to the assessment and management of patients with temporomandibular joint pain and dysfunction.

A prospective study of panic disorder in a Nigerian psychiatric out-patient population.

Fifteen corresponding to 3% of the 500 patients seen at the Out-patient Psychiatric Clinic of the University of Benin Teaching Hospital Nigeria between December 1985 and September 1986 met the DSM - III criteria for panic disorder. The female to male ratio was 3:1; the mean age of onset was 23.7 years and married patients dominated the group. Predisposing life events were present in four patients and in three of these the factors were multiple. Ten of the patients improved markedly on imipramine in an open drug trial design which lasted 3 months; the two non-responders had both situational and spontaneous panic attacks. The effect of social stressors as precipitants of panic attacks was highlighted.