A Review of the Evidence Base for Nutrition and Nutritional Supplements in Older Adults with Bipolar Disorder: A report from the OABD task force.

OBJECTIVES: To better understand the role of nutrition in older adults (aged 50 years or older) with bipolar disorders (OABD), we conducted a systematic review of the literature and appraise existing evidence. METHODS: Following PRISMA guidelines, we searched databases including Medline/PubMed, PsychINFO, EMBASE, CINAHL, Scopus, Web of Science, Cochrane Register, FDA website, and clinical trial registries through 2019 for eligible reports. The search string combined MeSH terms for bipolar disorder, nutrition and older adults. This was supplemented by snowball searching of references in relevant studies and authors were contacted to request their work where necessary. All included studies were rated with the National Institutes of Health Study Quality Assessment Tools based on study designs. RESULTS: Of 2280 papers screened, ten studies including eight observational and two interventional studies. The topic foci of the papers examined several nutrients, (including vitamin B12, vitamin D, coenzyme Q10, homocysteine, and folate), nutritional deficiencies and biochemical correlates. The prevalence rates of deficiencies varied with specific nutrients (3.7% to 71.6% for Vitamin B12 and 34.6% for Vitamin D), and between inpatient versus outpatient populations. While nutritional interventions appeared to be associated with improvement in both affective and cognitive outcomes, the sample sizes of OABD varied and were generally small. CONCLUSION: While there is evidence for the benefits of nutritional interventions on affective, cognitive and overall outcome in OABD, the quality of the evidence is limited. Our findings underscore the need for high quality studies to inform evidence-based guidelines for nutritional assessment and supplemention in OABD.

Psychosocial Wellbeing of Nigerian Teachers in Special Education Schools.

While there is evidence that impaired psychosocial wellbeing can compromise the effective performance of work-related roles, little is known about the wellbeing of teachers working with children with developmental disabilities. We interviewed 68 special education schoolteachers (response rate = 70.8%) in a Nigerian state with 12-item General Health Questionnaire and an adapted Zarit Burden Interview. About four in every ten teachers had psychological distress, representing many-fold the rates reported in the general population, and significant burden was prevalent in 51.5%. Perceived burden correlated significantly with psychological distress, anxiety/depression and social dysfunction (rs = .3). While increased burden predicted psychological distress, longer teaching experience was protective against distress. These findings underscore the need for psychosocial support for special education schoolteachers to enhance their wellbeing and roles.

A cross-sectional evaluation of the correlation between disease severity and quality of life in chronic rhinosinusitis patients in Nigeria.

Quality of Life (QoL) studies are increasingly being used as the primary outcome measure in chronic rhinosinusitis (CRS) globally. However, little is known about QoL and the interplay of identifiable factors on QoL in CRS in sub-Saharan Africa. This study investigated the correlation between disease severity and QoL in chronic rhinosinusitis patients. A total of 147 adults with subjective severity rating of CRS were studied. Participants were assessed using designed questionnaire, Individual Rhinosinusitis Symptom Severity Score Assessment (IRSSSA) and Rhinosinusitis Disability Index (RSDI) questionnaires to elicit socio-demographic/clinical profile, CRS symptom severity and QoL, respectively. The mean age of the participants was 36.86 ± 11.91 years. The mean severity score of all 147 CRS cases was 3.8 ± 1.13. The majority of participants (N = 80; 54.4 %) had moderate disease. The RSDI mean scores for the participants for overall HRQoL were 40.6 ± 19.8. (Median = 40; Range = 77), for physical domain 15.2 ± 7.7, functional domain 12.1 ± 6.4 and emotional domain 13.2 ± 8.2. The trend of association between the disease severity scores and the overall HRQoL on Pearson linear correlation indicates a positive linear association of worsening overall HRQoL with increasing disease severity (R = 0.83; P < 0.0001). The severity of CRS impacted negatively on the HRQoL. All domains were significantly affected by the disease severity particularly the physical domain. Patients adjudged severity of their disease and its' impact on their quality of life should be considered in the determination of the line of their management which could include psychosocial intervention.

Burnout among doctors in residency training in a tertiary hospital.

The mental health of doctors is an issue of growing concern all over the world as it frequently interplays with their professional trainings and responsibilities. This study was done to determine the pattern and correlates of burnout among 204 doctors undergoing residency training. Eligible participants were interviewed using designed questionnaire, General Health Questionnaire (GHQ-12) and Maslach Burnout Inventory (MBI). The mean age of participants was 33.44±4.50. Ninety-three (45.6%) respondents reported burnout in the dimension of emotional exhaustion (EE), 118 (57.8%) in the dimension of depersonalization (D), and 126 (61.8%) in the dimension of reduced personal accomplishment (RPA). Factors that were significantly associated with all the dimensions of burnout were perceived heavy workload and presence of emotional distress (based on GHQ score of ≥3). The perception of call duty as being not stressful was negatively predictive of burnout in the emotional exhaustion subscale (odds ratio [OR]=0.52; 95%confidence interval [CI]=0.29-0.97; p=0.03), while emotional distress was a positive predictor (OR=6.97; 95%CI=3.28-14.81; p<0.001]. Absence of doctor-to-doctor conflict negatively predicted burnout in the depersonalization subscale (OR=0.36; 95%CI=0.17-0.76); p<0.01), while older age (OR=0.66; 95%CI=0.47-0.95; p=0.03) and adequate support from the management (OR=0.45; 95%CI=0.22-0.90; p=0.02) constituted negative predictors of burnout in the reduced personal accomplishment subscale. Burnout is highly prevalent among resident doctors. Evolvement of comprehensive mental health services, training supports, conflict de-escalation/resolution mechanisms, and periodic assessment are indicated to mitigate work related distress with burn out among resident doctors, while improving their productivity.

Factors associated with anxiety disorders among HIV-positive attendees of an HIV clinic in Lagos, Nigeria.

Anxiety disorders (ADs) occurring in people living with HIV/AIDS (PLWHA) are often poorly identified in spite of the untold consequences that may result if not diagnosed and treated promptly. This study aimed to describe factors associated with ADs among PLWHA. Three hundred participants were administered sociodemographic/clinical profile questionnaires, and diagnoses of ADs were made using Schedule for Clinical Assessment in Neuropsychiatry (SCAN) based on International Classification of Diseases, 10th edition (ICD-10) criteria. In this study, 65 (21.7%) participants were diagnosed with ADs. A lack of family support, unemployment, younger mean age and being unmarried (P < 0.05) were factors associated with ADs in PLWHA; however, lack of family support (odds ratio [OR] = 0.458, 95% confidence interval [CI] = 0.254-0.827, P = 0.010), being unmarried (OR = 1.930, 95% CI = 1.046-3.560, P = 0.035) and unemployment (OR = 0.495, 95% CI = 0.264-0.926, P = 0.028) were the only factors that remained significant following logistic regression analysis. Prompt identification with active management of ADs and their associated factors among PLWHA are advocated. Further research on the risk factors for ADs is also warranted.