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This study examined the relationship between optimism and secondary traumatic stress (STS), including the mediating role of resilience on the association. Family carers (n = 194; female = 64.95%; m...

This study assessed the association between religiosity and treatment adherence, psychopathology of patients diagnosed with schizophrenia in a Nigerian psychiatric hospital. Duke University Religio...

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: Postpartum depression and anxiety could cause poor mother-infant relationship that could impair infant growth and cognitive development. Psychiatric assessment has not been part of periodic evaluations in postnatal clinics. Some apparently well, but high-risk mothers continue to live with psychological distress, without treatment to relieve their burden. Objectives: The study assessed the prevalence of postpartum anxiety and depression, their co-morbidity, and socio-demographic predictors, within 6 - 14 weeks postpartum among nursing mothers in two tertiary hospitals in Enugu, South-East Nigeria. Methods: A cross-sectional study that was carried out at the postnatal and children’s welfare clinics of two tertiary hospitals in Enugu, South-East Nigeria. Hospital Anxiety and Depression Scale, Social Support Scale and Socio-demographic Questionnaire were used for the study. Correlations and multiple regressions were used to test for associations and risk factors. Results: Occurrence rate for anxiety and depression were 30.1% and 33.3% respectively with a co-morbidity rate of 22%. Low social support and multigravida predicted risk factors for postpartum psychological distress, while a higher number of children alive predicted a decrease in the risk for postpartum psychological distress. Conclusion: The study supports service planning and the development of strategies to reliably identify women at high-risk, for effective treatment. Keywords: Postpartum Psychological Distress, Socio-demographic, Correlates, Apparently Healthy, Mothers, South-East Nigeria.

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.

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.

The study aims to compare the coping styles of patients with diabetes with those with depression. A total of 224 patients, 112 with depression and an equal number with diabetes were recruited. Sociodemographic variables were determined with the sociodemographic questionnaire, and coping styles with the Mental Adjustment to Cancer (MAC) adapted and Brief Religious Coping (Brief RCOPE) Scales. Fighting Spirit and MAC Summary Positive Adjustment were used more by participants with depression. Both groups of participants used the Brief RCOPE positive method to the same extent. Brief RCOPE negative was used more by participants with depression. Positive coping skills were used more by participants with depression than those with diabetes. This underscores the need for clinicians to explore the coping resources available to their patients, both religious and non-religious, and projecting them to their patients for enhancement and application as an adjunct for the purpose of a better clinical outcome.

Socioculturally influenced interpretations of mental illness play decisive roles on the time and choice of treatment. These often result in significant delays before patients present at the psychiatric services, with consequent worsening of the prognosis. The aim was to assess the association between sociocultural factors, choice of treatment and treatment delay among patients with schizophrenia. A cross-sectional study of 360 patients with schizophrenia, without previous contact with any statutory psychiatric services, was done. Of this, 75.8% of the participants had visited traditional/faith healers as the first treatment option and have attributed schizophrenia to magico-supernatural causation, despite 70.0% of the participants being educated, while 24.2% of them believed in the natural causation of the illness and presented early to psychiatric hospital. There is a need for community-based psychiatric services that would have mental health education as one of their core mandates; and collaborations wi...

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.

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

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.

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. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1433-0) contains supplementary material, which is available to authorized users.

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.

Introduction: Conversion disorder (CD) in children presents the clinician with a diagnostic and treatment dilemma. Mistaking a physical condition for CD carries serious consequences for the child while continued investigation in line with physical disease in a child with CD also may expose the child to serious harm. Materials and Methods: One hundred and seventy‑four consenting doctors who attended a national conference of pediatricians were administered a 10 item questionnaire developed by the researchers. Results: Only 5 (2.9%) of participants had good knowledge (scored above the mean plus one standard deviation of the score obtained by the psychiatry residents. Gender, rank, years of experience, availability of psychiatric service in center and duration of the psychiatry posting as the medical student could not differentiate those with good/fair knowledge from those without. However, those who have referred children for psychiatric assessment ( P = 0.015), those who believe that children can have CD ( P = 0.000) and those who are fairly confident that they could diagnose CD in children ( P = 0.000) had better knowledge of CD. Conclusion: Pediatricians have poor knowledge of CDs in children. Those that know that children could have the condition have confidence that they can identify children with the condition and have referred with mental health problems to psychiatrists have better knowledge than those who did not. Keywords: Conversion disorder, knowledge, pediatricians

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. Keywords: Socio-demographic correlates, schizophrenia, South-East Nigeria

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.

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.

Background : Pregnancy and labor in areas with high maternal morbidities as in Nigeria could be sufficiently stressful to precipitate mental disorders in women after delivery, which may be a new or a relapse of previously existing one, or an exacerbation of an attenuated mental illness in the nursing mother. Mental illness in a nursing mother, if not treated may result in impaired mother.infant relationship. Aim : To determine the clinical and socio.demographic characteristics of women diagnosed with postpartum psychiatric conditions in a tertiary mental health facility of a developing country. Subjects and Methods : A retrospective case note reviews of 76 women diagnosed with postpartum psychiatric conditions for the first time in the Federal Neuropsychiatric Hospital Enugu between January 2009 and December 2011. Results : The mean age of the women was 27.76 years, with 63% (48/76) of them coming from the rural areas. 93% (71/76) of them had at least a secondary education and 78% (59/76) of the women had a family history of psychiatric disorders. Schizophrenia was commonest, 48.7% (37/76) followed by depression, 22% (17/76) and mania, 15% (11/76). Those presenting with schizophrenia were younger when compared with other diagnostic groups, had a lower level of education and presented earlier for treatment. The husbands were the primary caregivers in 48% of them. Conclusion : With 63% (48/76) of them being rural dwellers, policy changes become imperative that would encourage establishment of psychiatric services in rural areas to ensure early detection and prompt treatment of postpartum women with a need for psychiatric services. Keywords : Clinical, Postpartum Mental disorders, Socio.demographic, Southeast Nigeria

There is a scant report in the literature on conversion disorder in children. These investigators are not aware of any report of this condition among Nigerian children. This could be because this condition is easily missed thus, creating the impression that conversion disorder is rare. This paper presents three cases of Nigerian children who manifested with features consistent with conversion disorder. This communication aims to highlight the need to consider this condition in children, especially those with difficult to explain symptoms.