Development and Validation of Cannabis Use Disorder Scale among University Undergraduates in Nigeria.

BACKGROUND: Psychoactive substance use continues to be an important public health issue among the populace, most especially in adolescents and young adults. Cannabis is one of the commonly used substances with associated health complications, hence the necessity for its screening among at-risk people. Thus, our study set out to develop and validate a screening inventory, the Cannabis Use Disorder Scale (CUDS) for cannabis use detection among undergraduate students in Nigeria. METHODS: In a cross-sectional study of selected undergraduate students in a Nigerian University, the Cannabis Use Disorder Scale (CUDS) was developed by the authors and validated against a standard instrument, Cannabis Use Problem Identification Test (CUPIT). RESULTS: The mean age of the 306 participants was 21.9±2.69 years, made up of 70.6% males and 29.4% females. The mean score on CUDS was 41.00, and a score above this indicates a positive screen for cannabis use. In terms of validity, there was a strong correlation between CUDS and CUPIT scores, with Pearson Product Moment correlation coefficient, r=0.722** at p=0.01 on concurrent validity; and with construct validity, the Kaiser-Meyer Olkin (KMO) test yielded a KMO of 0.900, while the Barlett's tests of sphericity yielded an approximate Chi-Square of 2820.00,df=300, at p<0.01.Again, Cronbach's alpha for CUDS was found to be 0.906**, and Guttman split-half reliability to be 0.862** at p<0.05. CONCLUSION: In this study, the newly developed cannabis use screening inventory, CUDS was found to be a valid and reliable instrument for use in Nigeria.

CONTEXTE: L'utilisation de substances psychoactives continue d'être un problème de santé publique important parmi la population, en particulier chez les adolescents et les jeunes adultes. Le cannabis est l'une des substances couramment utilisées avec des complications de santé associées, d'où la nécessité de le dépister chez les personnes à risque. Ainsi, notre étude visait à développer et valider une échelle de dépistage, l'Échelle des Troubles Liés à la Consommation de Cannabis (CUDS) pour la détection de la consommation de cannabis chez les étudiants universitaires au Nigéria. MÉTHODES: Dans le cadre d'une étude transversale menée auprès d'étudiants universitaires sélectionnés dans une université nigériane, l'Échelle des Troubles Liés à la Consommation de Cannabis (CUDS) a été développée par les auteurs et validée par rapport à un instrument standard, le Test d'Identification des Problèmes Liés à la Consommation de Cannabis (CUPIT). RÉSULTATS: L'âge moyen des 306 participants était de 21,9±2,69 ans, avec une répartition de 70,6 % d'hommes et 29,4 % de femmes. Le score moyen au CUDS était de 41,00, et un score supérieur à cela indique un dépistage positif de la consommation de cannabis. En termes de validité, il y avait une forte corrélation entre les scores du CUDS et du CUPIT, avec un coefficient de corrélation de Pearson de 0,722** à p=0,01 pour la validité concurrente ; et en ce qui concerne la validité de construit, le test Kaiser-Meyer-Olkin (KMO) a donné un KMO de 0,900, tandis que le test de sphéricité de Barlett a donné un Chi-Carré approximatif de 2820,00, df=300, à p<0,01. De plus, l'alpha de Cronbach pour le CUDS s'est avéré être de 0,906**, et la fiabilité en demi-split de Guttman était de 0,862** à p<0,05. CONCLUSION: Dans cette étude, la nouvelle échelle de dépistage de la consommation de cannabis, le CUDS, s'est révélée être un instrument valide et fiable pour une utilisation au Nigéria. Mots-clés: Consommation de cannabis; CUDS; Validation Nigéria.

Elevated plasma homocysteine in association with decreased vitamin B(12), folate, serotonin, lipids and lipoproteins in depressed patients.

OBJECTIVE: Increased plasma homocysteine, decreased vitamin B(12) and folic acid levels have been implicated in depressive mood. Plasma homocystine, vitamin B(12), folic acid tryptophan, lipids and lipoproteins were determined in depressed patients and controls. METHOD: Sixty subjects consisting of 30 depressed patients and 30 apparently healthy volunteers, who served as controls, were selected for this study. Anthropometric indices and biochemical parameters were determined using standard procedures. RESULTS: The results showed a significantly higher plasma homocysteine level amongst depressed patients when compared with the corresponding controls (p < 0.001), the percentage increase was 116%, while the plasma vitamin B(12) (p < 0.01), total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol levels (p < 0.001) were markedly lower when amongst depressed patients when compared with the corresponding controls; the percentage differences were 21%, 42% and 42% respectively. Plasma triglyceride, folic acid and tryptophan levels amongst depressed patients were not significantly different from the controls. The male subjects had significantly higher plasma tHcy levels than the female counterparts ( p < 0.001). CONCLUSION: This study showed a significant increase in plasma tHcy coexisting with a decrease in plasma vitamin B(12) TC, LDLC and HDLC, in depressed patients. Increased plasma homocysteine could be a sensitive indicator of plasma B vitamin deficiency.

An assessment of emotional pain among subjects with chronic dermatological problems in Lagos, Nigeria.

BACKGROUND: In dermatology, it is known that there is a significant co-morbidity between dermatological disorders and psychological complications, and it has been estimated that in at least one-third of patients with skin diseases, their effective management involves consideration of associated emotional factors. In Africa, particularly Nigeria, despite the prevalent dermatological disorders with their possible attendant mental health complications, little or no work has been done in the field of psycho-dermatology, hence the rationale for this study. METHODS: A prospective study was carried out in the dermatology/venerology clinic of Lagos University Teaching Hospital (LUTH). Ethical clearance and consent were obtained to conduct the study. The subjects were selected by simple random sampling from adult patients that have had their dermatological disorders for at least six months before presentation in the clinic. Those with other co-existing chronic medical illness such as hypertension, diabetes, or haemoglobinopathy were excluded from the study. Controls were obtained to match for age and sex from apparently healthy workers in a nearby general hospital. Each subject was evaluated with a questionnaire to obtain necessary socio-demographic data: Psychache scale (PAS), and subscales C, D, and J of Symptom Check List (SCL-90). The data generated was analyzed to obtain means, and t-test was used to compare the means; p = 0.05 was taken as being significant. The analyses were done using SPSS version 10. RESULTS: Eighty subjects with dermatological disorders, and of equal sex distribution, were evaluated, with mean age of 33 +/- 12.1 years. Equal number of controls matched for sex and mean age of 34.6 +/- 7.3 years were also evaluated. Among the subjects, 16.3% had Acne, followed by Urticaria (13.8%), Vitiligo (12.5%), Tinea (11.3%), Hansen's disease (5%), and others (41.1%). From assessment with PAS and SCL subscales, the mean scores by the subjects were much higher than those of the controls and in each group the males scored slightly higher than their female counterparts. On assessment with PAS, the subjects had much higher mean score of 28.94 +/- 12.61 and the controls: 18.92 +/- 7.1 with "t" of 6.19*; and the difference was statistically significant at p < 0.05 and critical "t" of 1.66. On SCL; subscale C, the mean scores for the subjects and controls were: 7.89 +/- 7.69 and 5.02 +/- 5.23 respectively and the difference was statistically significant with "t" of 2.75*. For subscale D, the mean score by the subjects was 11.09 +/- 10.56, and the controls had 4.84 +/- 6.08; and statistically significant difference with "t" of 4.59*. On subscale J, the subjects' mean score was 4.68 +/- 5.44, the controls: 1.98 +/- 3.19 with statistically significant "t" of 3.83*. CONCLUSIONS: The results showed that subjects with dermatological disorders suffered from significant emotional pain when compared to the healthy controls; the males had higher mean scores on PAS and SCL subscales, hence more likely to suffer emotional pain than their female counterparts. Finally, the need to have consultation-liaison psychiatry in the dermatology facilities in Nigeria was emphasized.

Postpartum depression in a maternity hospital in Nigeria.

OBJECTIVE: To explore the recognition and management of postpartum depression (PPD) by the obstetric team in a maternity hospital concomitantly, was to find the rate of PPD in the centre. DESIGN: A descriptive cross-sectional study. SETTING: Island Maternity Hospital, Lagos, Nigeria; a moderately large obstetric facility with 68 beds and 42 paediatric cots. SUBJECTS: The medical staff including doctors and nurse midwives in the study centre. Concomitantly, a sample of women that delivered in the hospital during the study period. RESULTS: Seventy two (65.5%) of the total 110 obstetric staff in the hospital consented to the study; made up of 10 doctors and 62 midwives of varying cadres. 43.1% of them admitted their difficulty to recognise PPD with X2 of 25.8, while 19.4% expressed doubt in the obstetric team's ability to manage PPD. 86.1% would rather refer PPD cases to the psychiatrists, but saw stigma as a militating factor. Hence 77.8% with X2 of 65.3 would want consultation-liaison psychiatric services established in the centre. Concomitantly, of the 252 women assessed with EPDS, 23% were depressed with scores >12. CONCLUSION: It is concluded that there is need to update the obstetric team's knowledge on the management of PPD through Continuous Medical Education (CME) to which 97.2% of them agreed.