Patterns of Substance Use Disorders and Associated Co-occurring Psychiatric Morbidity among Patients Seen at the Psychiatric Unit of a Tertiary Health Center.

Background: Understanding the pattern of co-occurring mental illness in patients with substance use disorders (SUDs) is essential in improving the prevention and treatment of substance use-related problems. This study examined the pattern of SUDs, the associated co-occurring psychiatric morbidities, and associated factors among patients with SUDs managed at a tertiary health center. Methods: The records of patients who presented with SUDs between 2010 and 2019 were examined. Socio-demographics of interest were extracted from case files. Substance use diagnoses, as well as associated co-occurring mental illness, were extracted and entered into SPSS software. Bivariate analyses including the risk of developing co-occurring mental disorder were calculated. Findings: For most patients, the initiation of substance use was before the age of 21 years, while the onset of SUDs was between 21-30 years. Cannabis use disorders (CUDs), alcohol use disorders (AUDs), and nicotine use disorders (NUDs) were the commonest SUDs. Compared with those with CUDs, non-users of cannabis were significantly less likely to develop co-occurring mental illness [odds ratio (OR) = 0.25, 95% confidence interval (CI) =0.13-0.42, P = 0.001]. Those with tramadol use disorders (OR = 2.13, 95% CI = 1.03-4.41, P = 0.040) and those without pentazocine use disorders (P = 0.003) were more likely to have a comorbid mental illness. Patients with AUDs (P = 0.001), CUDs (P = 0.001), NUDs (P = 0.001), and tramadol use disorders (P = 0.045) were significantly more likely to be multiple substance users. Conclusion: Results suggest an association between SUDs and co-occurring mental illness, though differences in these associations were noticed across the categories of substances. This emphasizes a holistic approach to prevention and care of patients presenting with SUDs.

Comparison of Anxiety and Depression Among HIV-Positive and HIV-Negative Pregnant Women During COVID-19 Pandemic in Ekiti State, Southwest Nigeria.

Purpose: Coronavirus disease 2019 (COVID-19) pandemic is the significant public health crisis of the 21st century that has disrupted personal, local, and international territorial relationships. Earlier studies have shown that people with HIV were at least twice at risk of dying from COVID-19 than the general population. There are also deep concerns about the indirect impact of COVID-19 on women within the reproductive age group in Sub-Saharan Africa who were already struggling to access reproductive healthcare services. In addition, pregnant HIV-positive women have an increased rate of anxiety and depression. This study, therefore, examined depression and anxiety disorders in pregnant HIV-positive women in response to the COVID-19 pandemic. Patients and Methods: This cross-sectional study used a structured questionnaire containing sociodemographic information, Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder-7 (GAD-7) assessment tools. Data obtained were analyzed using Statistical Package for Social Science version 26. Results: Ninety-nine (99) representing 78% of 127 pregnant HIV-positive women enrolled in the PMTCT program were eligible for this study. This number matched 99 randomly selected pregnant HIV-negative in the study areas as controls. Major depressive disorder (MDD) and severe anxiety disorder were significantly higher among the HIV-positive group than in the HIV-negative group (PHQ-9 Mean ± SD 8.0 ± 5.4 vs 2.3 ± 2.9; p = 0.000) and (GAD-7 Mean ± SD 5.9 ± 4.6 vs 1.2 ± 2.2; p = 0.000). Conclusion: Given the high prevalence of major depressive disorder and severe anxiety disorder among pregnant HIV-positive women, mental health care should be incorporated into the prevention with positive interventions and strategies to reduce the indirect consequences of the COVID-19 pandemic.

Hazardous alcohol use among doctors in a Tertiary Health Center.

BACKGROUND: Doctors have been identified as one of the key agents in the prevention of alcohol-related harm, however, their level of use and attitudes toward alcohol will affect such role. AIM: This study is aimed at describing the pattern of alcohol use and the predictors of hazardous drinking among hospital doctors. SETTING: Study was conducted at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. DESIGN: A cross-sectional survey involving all the doctors in the teaching hospital. MATERIALS AND METHODS: All the consenting clinicians completed a sociodemographic questionnaire and alcohol use was measured using the 10-item alcohol use disorder identification test (AUDIT) and psychological well-being was measured by the 12-item General Health Questionnaire (GHQ-12). STATISTICAL ANALYSIS USED: Statistical analyses were done using the Statistical Package for Social Sciences version 16. Chi-square tests with Yates correction were used to describe the relationship between respondent's characteristics and AUDIT scores as appropriate. RESULTS: There were a total of 122 participants. Eighty-five (69.7%) of them were abstainers, 28 (23%) were moderate drinkers, and 9 (7.3%) hazardous drinkers. With the exception of age, there was no significant relationship between sociodemographic status, years of practice, specialty of practice, and hazardous alcohol use. Experiencing stress or GHQ score above average is significantly associated with hazardous drinking. CONCLUSION: Hazardous drinking among hospital doctors appears to be essentially a problem of the male gender, especially among those older than 40 years. Stress and other form of psychological distress seem to play a significant role in predicting hazardous drinking among doctors.

Assessment of Depression in a Primary Care Setting in Nigeria using the PHQ-9.

CONTEXT: Mental disorders are major contributors to the burden of diseases all over the world. In general practice, which provides essentially primary care, depression is the most common mental disorder seen and often goes unrecognized. AIMS: The aims of the study were to determine the prevalence of depression, the variables associated with depression, and the degree of recognition by the Physician in family medicine unit. SETTING AND DESIGN: A cross-sectional descriptive survey of consecutive patients who presented at the general medical out-patient unit of the State University Teaching Hospital, Ado-Ekiti, Nigeria was done. MATERIALS AND METHODS: Data were collected using a questionnaire incorporating sociodemographic variables and primary diagnosis made by attending Physician. Depression was assessed with the PHQ-9. RESULTS: Two hundred and seventy two patients were interviewed during the period of the study. Participants were mostly of 45 years or older (51.2%), female (59.9%), married (68.4%), and educated (85.7%). One hundred and thirty (47.8%) of the respondents had significant depressive symptoms with majority (49.2%) being classified as mild. Statistical analysis revealed significant association between depression and age, gender, marital status, and clinical diagnoses (P < 0.05). Over a quarter (28.7%) were presented with infectious diseases, other diagnoses made included cardiovascular disorders (15.8%), endocrine disorders (8.8%), psychiatric disorders other than depression (2.9%) and none had depression as primary diagnosis. CONCLUSIONS: The prevalence of depression among patients attending the general medical out-patient clinics is high and highly under-recognised.

Olanzapine as a cause of urinary incontinence: a case report.

Olanzapine, an atypical antipsychotic, is one of the most commonly used antipsychotics. Though olanzapine is commonly associated with endocrine side effects, it is generally well tolerated by most patients and is rarely associated with urinary incontinence. This report highlights the case of a 23 -year old male patient with schizophrenia who developed severe urinary incontinence following the use of olanzapine. No medications were given to relieve the incontinence contrary to some other studies where ephedrine was used. Olanzapine was changed to trifluoperazine, and the patient's condition improved within two days. Urinary incontinence, though uncommon, is an embarrassing side effect of olanzapine which could negatively affect drug compliance. As such, clinicians should enquire about it in order to improve the patient's health.