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Background: Diagnosis of ADHD depends on manifestation of symptoms in at least two different settings. This therefore emphasizes the importance of multiple informants, parents and teachers. However perception could differ because of differences and inconsistencies across different settings. This is particularly important in rural settings in Africa where the educational attainment and outlook of teachers are very different from those of the parents.The study is aimed at comparing the presentations of children with ADHD in the rural area, across two different settings: home and school. Methods: The teachers of 181 rural primary school children in Ogberuru in Imo state, south eastern, Nigeria completed the school version of ADHD rating scale-IV, and their parents completed a Socio demographic questionnaire and the home versions of the ADHD rating scale-IV. Results: Of the 18 symptoms of the condition, there were significant differences in the rate of identification in eight symptoms. These symptoms include ‘being easily distracted’ (p=0.0427), ‘difficulty following through on instruction’ (p=0.0026), ‘fails to give close attention to details (p=0.0001), ‘avoids tasks necessary for tasks’ (p=0.0013), ‘difficulty playing quietly (p=0.0059 ), ‘talks excessively’ (p=0.0023), ‘intrudes on others’ (p=0.0004), and ‘seems not to listen when spoken to directly’ (p=0.0002). They were all consistently more manifest in school settings than in their homes. Conclusion: Teachers identified ADHD symptoms more commonly than parents. They could therefore play critical roles in programs aimed at improving early identification and management of children with ADHD especially in rural Africa where healthcare facilities are scarce

Background: It is important to establish the pattern of suicidal ideation among adolescents with depression and anxiety. This will help the schools prevent possible complete suicide among these groups of adolescents' trough counseling and education., Objectives: This work is therefore aimed at determining the effects of depression and anxiety on adolescent suicide ideation and factors that predict suicidal ideation among adolescents attending secondary school in southeast Nigeria., Methods: A cross-sectional study among 450 secondary school adolescents in Enugu state, Nigeria. Information was obtained using the Columbia suicide severity rating scale and the Hospital Anxiety and Depression Scale (HADS). Chi-square test, correlation analysis and Hierarchical logistic regression were used in the analysis, and the level of statistical significance was determined using a P-value of <0.05., Results: The prevalence of anxiety was 36.4% while that of depression was 30.7%. The prevalence of suicidal ideation was 8.4%. The prevalence of suicidal ideation among adolescents who were <15 years was 8.0% while those who were between 15 - 18 years was 13.5% and those more than 19 years of age was 22.5%. The prevalence of suicidal ideation among adolescents with depression is 21.7% and 78.3 % for those without depression while the prevalence of suicidal ideation among adolescents with anxiety is 20.1% and 79.9 % for those without anxiety. The prevalence of suicidal ideation among the poorest half was 16.4% and 10.2% in the richer half. There was a higher prevalence of suicidal ideation among the urban dwellers (53.3%) than the rural dwellers (46.7%).There was a positive correlation between suicide and age in years and this was found to be statistically significant, (n=450, r=0.107, p=0.023). A significantly higher proportion of respondents who had depression, 21.7% had suicidal ideation when compared with those who were not, ( χ 2 =12.170, p<0.001). Similarly, a significantly higher proportion of respondents who had an anxiety disorder, (20.1%) had suicidal ideation when compared with those who were not, 9.4%, ( χ 2 =10.291, p=0.001). The respondents who were 19 years and above had increased suicidal ideation, and the difference in proportions was found to be statistically significant, ( χ 2 =6.440, p=0.040). A significantly higher proportion of females, 16.6% had suicidal intentions when compared with the males, 7.1%, ( χ 2 =7.958, p=0.005)., Conclusion: There is an increasing prevalence of suicidal ideation among adolescents with a preponderance of older age and female gender. There is a link between depression/anxiety and suicidal ideation. The prevalence of suicidal ideation among the poorest half was higher than that of the richer half. There was a higher prevalence of suicidal ideation among the urban dwellers than the rural dwellers., Competing Interests: The authors declare that they have no competing interests., (© 2023 Chinawa TA et al.)

Background: Adolescent problem gambling is a common behavioural issue and could be associated with internet addiction., Objectives: To determine the pattern of problem gambling and factors that predict gambling among adolescents that attended secondary schools in southeast Nigeria., Methodology: This is a cross-sectional study design. A three-stage sampling technique was used to select 796 secondary school adolescents from eight secondary schools in Enugu State, Nigeria., Results: The highest proportion of the respondents, 38.3% had problem gambling with negative consequences. There was a weak positive correlation between gambling severity index and internet addiction. (n=796, r=0.254, p<0.001). There is a very weak negative correlation between gambling severity index and age in years. (n=796, r= -0.034, p=0.331).The male respondents were 1.5 times more likely to have problem gambling when compared with the females, (AOR=1.5; (95%CI: 1.1-2.0). The respondents who have internet addiction were 3.5 times more likely to have problem gambling when compared with those who do not have an internet addiction, (AOR=3.5; 95%CI: 2.6-4.8)., Conclusion: The prevalence of gambling among adolescents is high. Adolescents who had problem gambling also had internet addiction. The male respondents were more likely to have problem gambling than their female folk., (© 2023 Chinawa AT et al.)

This study assessed dependent personality, marital satisfaction, and mindful awareness and their association with postpartum depression and anxiety. It was a cross-sectional study of nursing mothers, within 6-14 weeks postpartum, at the postnatal and children's welfare clinics of two tertiary hospitals in Enugu, southeastern Nigeria. The nursing mothers responded to different questionnaires that measure each of these variables. Correlations and multiple regression analyses were used to measure the strength of association between the variables in the study and to identify predictors for the outcome variables of interest, respectively. Low mindful attention awareness, poor marital satisfaction, and low dependency predicted an increased risk of postpartum depression and anxiety, with low mindful attention awareness as the strongest predictor. The findings from the study carry significant implications for the roles of dependent personality, marital satisfaction, and mindful awareness in the etiology of postpartum depression and anxiety in Southeast Nigeria.

Background: Many studies have noted the high prevalence of post-partum depression (PPD) and anxiety associated with poor marital satisfaction, albeit amidst a dearth of literature on comorbid PPD and anxiety among women in Nigeria., Objective: The study was aimed to assess the prevalence of PPD and anxiety, and to investigate their relationship with marital satisfaction in low-risk women in Enugu, Southeastern Nigeria., Method: A cross-sectional study of 309 randomly selected nursing mothers at two tertiary health institutions. Socio-demographic Questionnaire, Hospital Anxiety and Depression Scale, and Index of Marital Satisfaction (IMS) were used to collect data on demography, anxiety and depression and marital relationship respectively. All statistical tests were performed at a significant level of 0.05., Results: The age range of the respondents was 20-46 years; mean and s.d. was 29.65 and ± 4.87, respectively, and most of them were graduates of tertiary educational institutions (74.1%). The prevalence of post-partum anxiety was 31.1% and of PPD was 33.3%. Marital dissatisfaction was observed in 39.5% (122) of the respondents who were mothers. Those with co-morbid depression and anxiety (22.0%) had worse marital dissatisfaction. The strongest correlation with depression and anxiety was item 12 of IMS ('feel that my partner doesn't confide in me')., Conclusion: There was a high prevalence of marital dissatisfaction, PPD and anxiety among nursing mothers in Enugu, but with low detection rate. The effects of PPD and anxiety on the mother, her marital relationship and her infant make them essential conditions for early diagnosis, prevention and treatments., Competing Interests: The authors declare that they have no financial or personal relationships which may have inappropriately influenced them in writing this article.

Objectives: To assess the prevalence and factors associated with perceived stress among medical students., Methods: A cross-sectional study of students (n=623) selected across eight medical schools in Nigeria. A structured questionnaire obtained socio-demographic characteristics, alcohol use (Alcohol Use Disorders Identification Test), other psychoactive drug use (Drug Abuse Screening Test), anxiety/depression symptoms (Hospital Anxiety Depression Scale) and stress (Perceived Medical School Stress Scale). We performed bivariate analysis using the chi-squared test, t-test and one-way ANOVA, with multiple regression analysis for multivariate testing in analysing the data., Results: Most students reported experiencing medical school stress. Female participants were more likely to perceive medical school as competitive (t (621) =1.17, p=0.003), less likely to see medical school as a threat (t (621) =-2.70, p=0.01) or worry about finances (t (621) =-4.80, p=0.001). Nearly a quarter; 21.3% (n=133) and 28.6% (n=178) reported depression and anxiety symptoms respectively. Approximately 4.2% (n=26) were dependent on alcohol, while 14.1% (n=88) had 'low-risk use' for other psychoactive substances. In the multiple regression model, lack of finance (B=2.881, p=0.001), weak adherence to religious faith (B=2.376, p=0.001), anxiety symptoms (B=-2.231, p=0.002), problematic alcohol use (B=5.196, p=0.001) and choice of study influenced by parents (B=-3.105, p=0.001) were predictors of greater perceived stress., Conclusions: Medical students in Nigeria report high levels of stress. Incorporating stress reduction strategies in the medical curriculum, and the input of students in providing feedback regarding the methods and styles of undergraduate medical education is required.

Objective: To determine the prevalence of ADHD among primary school pupils in a rural community in Southeastern Nigeria and to determine the psychosocial factors associated with the condition., Method: One hundred eighty-one randomly selected participants had their teachers complete the school version of ADHD Rating Scale-IV. Their parents also completed a sociodemographic questionnaire, the clinical interview form for the child and adolescent ADHD patients, and home version of the ADHD Rating Scale-IV., Results: Twelve (6.6%) of the children met the criteria for diagnosis. A history of prolonged labor (odds ratio [OR] = 14.1; 95% confidence interval [CI] = [2.13, 93.1]), and parents' negative assessment of their marriages (OR = 0.1; CI = [0.017, 0.567]) were the most predominant factors which independently associated with the ADHD in the children., Conclusion: There is, therefore, a need for the care of rural dwelling African children, who otherwise would have difficulties accessing health care that is concentrated in the cities.

A significant proportion of patients treated for schizophrenia respond poorly to medication. Few studies have systematically examined the impact of clinical characteristics of patients to antipsychotic response in our environment. The study aimed to identify clinical variables associated with response in patients with schizophrenia. A total of 172 participants diagnosed with schizophrenia, placed on antipsychotics, who presented for the first time to the hospital or have stopped medication in the preceding six months, whose responses were assessed after four to six weeks were studied. Improvement was defined as 20% or greater reduction in PANSS scores. Good response was associated with good medication adherence, good pre-morbid functioning, fewer negative symptoms, less cognitive impairment, absence of co-morbid personality disorder, and short duration of untreated psychosis. Due consideration of the impact of clinical variables could help detect poor responders early, hence avoiding unnecessary exposure to ineffective treatments and their side effects while effective interventions are delayed.

Background: Many patients with schizophrenia respond poorly to antipsychotic medication. Few studies have systematically examined the relationship of social and demographic characteristics of these patients to treatment response in our environment., Objective: To identify the social and demographic variables associated with treatment response in patients with schizophrenia., Method: A total of 172 participants with a diagnosis of schizophrenia receiving antipsychotics took part in the study. Participants were consecutively recruited involving patients presenting for the first time, or relapsed patients who had stopped antipsychotics in the previous six months. Both in-patients and out-patients who met the inclusion criteria were studied. Socio-demographic interview schedule and the Positive and Negative Syndrome Scale (PANSS) were administered at the initial encounter and between 4 and 6 weeks, subsequently., Results: Defining good treatment response as ≥ 20% reduction in PANSS score, 68% had a good response while 32% had poor response. Good response to treatment was associated with late age of onset of illness, satisfactory family relationship, acquisition of skilled occupation and being married. However, there was no association between treatment response and gender., Conclusion: Knowledge about these variables in relation to treatment response would improve mental health services as regards articulation of prognosis and psycho education.

Background: Religion is a powerful coping strategy. Diabetes and depression are common conditions in our environment that induce psychological distress, thus requiring coping for better outcome. Studies indicate that increased religiosity is associated with better outcome in clinical and general populations. Therefore, studies of the distribution of religiosity and religious coping among these populations are essential to improve outcome., Objectives: To assess the association between religiosity, religious coping in depression and diabetes mellitus, and selected sociodemographic variables (age, gender and occupational status)., Methods: Using simple random sampling we recruited 112 participants with diabetes and an equal number with depression consecutively, matching for gender. Religiosity was determined using religious orientation scale (revised), religious coping with brief religious coping scale and socio-demographic variables with a socio-demographic questionnaire., Results: Intrinsic religiosity was greater among older people with depression than among older people with diabetes(t=5.02,p<0.001); no significant difference among young people with depression and diabetes(t=1.47,p=0.15).Positive religious coping was greater among older people with depression than among older people with diabetes(t=2.31,p=0.02); no difference among young people with depression and diabetes(t=0.80,p=0.43). Females with depression had higher intrinsic religiosity scores than males with depression(t=3.85,p<0.001); no difference in intrinsic religiosity between females and males with diabetes(t=0.99,p=0.32).Positive religious coping was greater among participants with diabetes in the low occupational status(t=2.96,p<0.001) than those in the high occupational status., Conclusion: Religion is indeed a reliable coping method, most commonly used by the elderly and females with depression. Positive religious coping is more common among diabetic patients who are in the low occupational status.

Objective: The study assesses the association between religiosity and coping style with the outcome of depression and diabetes., Method: Using a simple random sampling, we recruited 112 participants with diabetes and an equal number with depression consecutively, matching for gender. Religiosity was determined using Religious Orientation Scale (revised) (ROS-R), coping styles with Brief Religious Coping (Brief RCOPE) scale and Mental Adjustment to Cancer (MAC) scale (adapted). Primary and secondary outcomes were evaluated using Sheehan's Disability Scale (SDS) and Becks Depression Inventory-II (BDI-II) respectively., Results: Among participants with diabetes, BDI-II total scores correlated negatively with ROS-R Extrinsic Social (r = -0.2, P < 0.05) and Fighting Spirit (r = -0.3, P < 0.05) but correlated positively with Helplessness/Hopelessness (r = 0.3, P < 0.05) and Brief RCOPE Negative (r = 0.4, P < 0.05). SDS global scores correlated positively with Helplessness/Hopelessness (r = 0.3, P < 0.05) and Brief RCOPE Negative (r = 0.4, P < 0.05). Among participants with depression, BDI-II total scores correlated negatively with Intrinsic religiosity (r = -0.2, P < 0.05) and Fighting Spirit (r = -0.4, P < 0.05) but correlated positively with Helplessness/Hopelessness (r = 0.6, P < 0.05) and Brief RCOPE Negative (r = 0.7, P < 0.05). SDS global scores correlated negatively with Intrinsic religiosity (r = -0.2, P < 0.05) and Fighting Spirit (r = -0.3, P < 0.05) but correlated positively with Helplessness/Hopelessness (r = 0.5, P < 0.05) and Brief RCOPE Negative (r = 0.4, P < 0.05)., Conclusion: High intrinsic and extrinsic religiosities are likely to be associated with positive coping skills and better treatment outcome in patients with depression or diabetes., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Earlier studies suggest that knowledge about Autism Spectrum Disorder (ASD) among healthcare workers in Nigeria is low. This present study assessed the knowledge of Nigerian final year medical students about symptoms of ASD and some other aspects of ASD. This is a cross sectional descriptive study that drew a total of seven hundred and fifty-seven (757) final year medical students from ten (10) randomly selected fully accredited medical schools out of a total of twenty-seven (27) fully accredited medical schools in Nigeria. Sociodemographic and Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaires were used to assess knowledge of final year medical students about ASD and obtain demographic information., Results: Only few, 218 (28.8 %) of the 757 final year medical students had seen and participated in evaluation and management of at least a child with ASD during their clinical postings in pediatrics and psychiatry. Knowledge and recognition of symptoms of ASD is observed to be better among this group of final year medical students as shown by higher mean scores in the four domains of KCAHW questionnaire. Knowledge about ASD varies across gender and regions. Misconceptions about ASD were also observed among the final year medical students., Conclusions: More focus needs to be given to ASD in the curriculum of Nigerian undergraduate medical students, especially during their psychiatry and pediatric clinical postings.

A large proportion of psychiatric patients in Nigeria seek help from other sources which ultimately lead to treatment delay. Treatment delay could have deleterious effects on treatment outcome especially for people with schizophrenia. The study aimed to determine the socio-demographic characteristics associated with treatment delay in people with schizophrenia. This was a cross-sectional study of 367 patients with schizophrenia presenting for the first time at a psychiatric hospital. About 76% of them had visited traditional/faith healers as a first treatment option. Long distance and use of traditional healers as first treatment option were associated with treatment delay. There is need for effective community psychiatry service delivery with emphasis on those strategies that can educate, influence, and mobilize communities concerning the aetiology, prevention, early detection, and treatment of mental illness.

Mental hospital-based data on child and adolescent psychiatric services are uncommon in low-resource countries, although such data are important for service development and planning. Data are reported on neuropsychiatric diagnoses and psychotropic medication prescription in a child and adolescent psychiatric service in southeastern Nigeria. Schizophrenia-like and other psychotic disorders, followed by seizure disorders, were the most prevalent, while the least prevalent included autism spectrum disorders, enuresis, adolescent postpartum psychosis, and adjustment disorders, among others. Most frequently prescribed psychotropic medications included antipsychotics, benzodiazepines, and antiepileptics (either for seizure disorders or as mood stabilizer). Antidepressants and stimulants were not commonly prescribed.