Longitudinal Factor Structure of the Brief Psychiatric Rating Scale Among Incident Cases of Schizophrenia Attending a Nigerian Hospital.

Background: Schizophrenia, from its early conceptualization, has been described in distinct clinical subtypes. However, these categories were found not to be stable phenotypes over time, hence the dimensional option, whereas at cross-sectional level, the dimensions of psychopathology have been replicated across studies; there is dearth of data on the longitudinal stability of the factor structure of the symptoms of schizophrenia in African populations. Aim: This study examined the longitudinal stability of the factor structure of the 18-item Brief Psychiatric Rating Scale (BPRS) across intervals of 16-week naturalistic treatment follow-up. Patients and Methods: Consecutive incident cases that fulfilled the criteria for schizophrenia were recruited into the study. After a baseline assessment, 160 incident cases of schizophrenia were followed up 4 weekly for indicators of symptomatic outcome for 16 weeks. The Brief Psychiatric Rating Scale (BPRS) assessments were conducted in clinical interviews and with the Scale for Assessment of Negative Symptoms (SANS). Five BPRS assessments were made across the monthly intervals of follow-up. Exploratory factor analyses (EFA) using maximum likelihood extraction and varimax rotation with Kaiser normalization was used to extract the factors. Results: A four-factor structure was found at baseline, namely negative, positive, depressive/anxiety, and manic symptom dimensions. From week 4, the manic and anxiety/depression dimensions remained invariant over time, while negative and positive symptoms merged into a psychosis dimension that was invariant. Conclusion: The persistence of the mood dimensions supports the DSM-5 recommendation to include these dimensions in the assessment of schizophrenia psychopathology. The longitudinal emergence and invariance of the psychosis factor echo the idea of unitary psychosis and, along with the prominence of mood dimensions over time, reflect recent molecular genetic findings about the sharing of genes by schizophrenia and mood disorders.

Dimensional approach to gender dysphoria in Nigeria: Association with socio-demographic and psycho-sexual variables.

Background: Recent changes across the world with respect to gender transitioning of children and adolescents have generated a bio-psycho-socio-cultural discourse among interest groups. Aim: This study sought to examine gender dysphoric symptoms among adolescents and young persons in an African population, using a dimensional approach. Method: A total of 747 primary/secondary school and university students aged 10-24 years were studied using the 27-item Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA). Participants were divided into early, mid- and late adolescents. The composite and domain scores were calculated using the criteria described by Deogracias, and comparison of the median scores was done using Mann-Whitney U-test and Kruskal-Wallis test as appropriate. Dunnett's post-hoc test was used for pairwise comparisons. Results: The prevalence of self-identified transgender and self-reported non-heterosexuals was 0.9% (95%CI: 0.36-1.92) and 18.6% (15.85-21.59), respectively. The participants as a group scored 4.56 out of a possible 5 on the gender dysphoria scale, indicating less gender dysphoric symptoms in this cohort. However, participants in mid- and late adolescents had significantly lower scores when compared with early adolescents (P = 0.009). Self-reported transgender had significantly lower scores in the social (P = 0.001) and socio-legal (P < 0.001) indicators of the scale. Conclusion: The findings of this study, although, preliminary demonstrated less gender dysphoric symptoms in this cohort of Nigerian adolescents and young adults compared to the Western population. Nevertheless, some degree of GD was noticed, revealing that this condition is existent in our society.

Nutritional status of primary school children: Association with intelligence quotient and academic performance.

BACKGROUND: Nutrition plays a pivotal role in brain development throughout life. Sub-optimal intellectual ability and poor school performance are said to be among the long term effects of malnutrition. The aim of this study was to determine the association between nutritional status of the participants, their intelligence quotient (IQ) and academic performance. METHODS: Children aged 6-12 years who met the inclusion criteria were recruited from the public and private primary schools in the local government area using a proportionate multistage sampling technique. Weight and height were measured using standard protocols and interpreted as normal or abnormal using the World Health Organization AnthroPlus®. IQ was assessed using the Raven's Standard Progressive Matrices and was grouped into optimal and suboptimal. Academic performance was assessed using the past records of class assessment, and was classified into high, average and low academic performance. A semi-structured questionnaire was used to obtain data such as-age, gender, socioeconomic indices and family size of the study participants. RESULTS: The prevalence of underweight, thinness (wasting), stunting, overweight and obesity were 2.0%, 3.6%, 2.1%, 6.7%, and 4.2%, respectively. Indices of over-nutrition were significantly associated with optimal IQ and good academic performance. There was a trend in the association between wasting and suboptimal intelligence [AOR (95%CI) = 1.5 (1.0-3.0), p = 0.06]. CONCLUSION: Acute and chronic under-nutrition did not adversely affect the IQ and academic performance of the study population. The relationship between over-nutrition, IQ and academic performance disappeared when socio-economic status was controlled for.