Depression in Patients with Epilepsy: A Study from Enugu; South East Nigeria

Depression is a common psychiatric disorder in epilepsy patients. A bidirectional interaction is thought to be present between epilepsy and depression. There are few studies of this relationship in Nigerian Africans. Objectives: This was a cross-sectional study of the frequency and pattern of depression in a cohort of epilepsy patients in Enugu; South East Nigeria. Materials and Methods: Adult patients with epilepsy seen at the University of Nigeria Teaching Hospital; Enugu; from May to September 2009 were assessed for depression using the Becks Inventory for Depression. Informed consent was obtained from each patient. Clinical data obtained were analyzed using Statistical Package for the Social Sciences; version 15. The hospital's ethical review committee approved the study. Results: I0 n all; 83 subjects were studied (50 males and 33 females). They were aged from 18 to 75 years; with an average of 29.87 years. Most subjects were 25 years of age; single (53; 64) and had at least secondary school education (65; 78). Depression was present in 71 (85.5) subjects - minimal 57 (68.7); mild 10 (12); and moderate 4 (4.8). No case of severe depression was seen. Patients 25 years of age were the most affected. Depression was not significantly associated with age; gender; seizure type; or educational level. Conclusion: A significant proportion of Nigerian African epilepsy patients have depression; which may be easily overlooked; with far-reaching consequences on patients' quality of life; morbidity; and mortality rates. There is need to regularly assess for and manage epilepsy-related depression in this population

Psychological and Social Adjustment to Blindness: Understanding from two groups of Blind People in Ilorin; Nigeria

Background: Blindness can cause psychosocial distress leading to maladjustment if not mitigated. Maladjustment is a secondary burden that further reduces quality of life of the blind. Adjustment is often personalized and depends on nature and quality of prevailing psychosocial support and rehabilitation opportunities. This study was aimed at identifying the pattern of psychosocial adjustment in a group of relatively secluded and under-reached totally blind people in Ilorin; thus sensitizing eye doctors to psychosocial morbidity and care in the blind. Materials and Methods: A cross-sectional descriptive study using 20-item Self-Reporting Questionnaire (SRQ) and a pro forma designed by the authors to assess the psychosocial problems and risk factors in some blind people in Ilorin metropolis. Result: The study revealed that most of the blind people were reasonably adjusted in key areas of social interaction; marriage; and family. Majority were considered to be poorly adjusted in the areas of education; vocational training; employment; and mobility. Many were also considered to be psychologically maladjusted based on the high rate of probable sychological disorder of 51; as determined by SRQ. Factors identified as risk factors of probable psychological disorder were poor educational background and the presence of another medical disorder. Conclusion: Most of the blind had no access to formal education or rehabilitation system; which may have contributed to their maladjustment in the domains identified. Although their prevailing psychosocial situation would have been better prevented yet; real opportunity still exists to help this group of people in the area of social and physical rehabilitation; meeting medical needs; preventive psychiatry; preventive ophthalmology; and community health. This will require the joint efforts of medical community; government and nongovernment organizations to provide the framework for delivery of these services directly to the communities

Influence of Gender and Age on Psychosocial Adjustment of People Living with HIV/AIDS in Calabar; Nigeria

Purpose: Health and adjustment to chronic health conditions are often affected by various sociodemographic variables. This study assessed the influence of gender and age on the psychological; social and spiritual adjustment of people living with HIV/AIDS in Calabar; Cross River State; Nigeria. Materials and methods: A comparative descriptive research design was adopted to study 280subjects selected from two health facilities within the study area. A validated adjustment questionnaire was the instrument for data collection while stratified random sampling involving balloting with replacement was used for sample selection. Results: Results showed a significant influence of gender on the respondents' psychological; social and spiritual adjustment (Cal.t=7.89; 4.05; 3.78 Crit.t=1.96). The males adjusted better than the females. Similarly; age of respondents exerted significant influence on psychological adjustment (Cal.F=5.54 Crit.F.=2.37) but not on social and spiritual adjustment (Cal.F=1.67; 0.56 Crit.F

Religious beliefs, coping skills and responsibility to family as factors protecting against deliberate self-harm

Background. Deliberate self-harm (DSH) ranges from behaviours aiming to communicate distress or relieve tension; but where suicide is not intended, to suicide. Not all individuals are prone to DSH, which suggests that there are factors that protect against it. Identifying these could play an important role in the management and prevention of DSH. Objectives. This study examined whether religious beliefs, coping skills and responsibility to family serve as factors protecting against DSH in Kota Kinabalu, Sabah, Malaysia. Method. A cross-sectional comparative study assessed DSH patients consecutively admitted or directly referred to Queen Elizabeth General Hospital and Hospital Mesra Bukit Padang during the period December 2006 - April 2007. DSH patients (N=42) were matched with controls (N=42) for gender, age, religion, race, occupation and marital status. The DSH and control groups were compared using psychosocial tests that assess coping skills, religious beliefs and responsibility to family. Results. There were significant differences in religious beliefs (p=0.01) and responsibility to family (p=0.03) between the DSH patients and the control group. There were also significant differences in coping skills, DSH patients tending to use emotion-orientated coping (p=0.01) as opposed to taskand avoidance-orientated coping. caution is required in generalising the results owing to limitations of the study. Further extensive research on religious and psychotherapeutic interventions and prospective studies on protective factors will be helpful

Psychosocial Adjustment of Children Affected by HIV/AIDS in Ghana

Objective: The study was conducted to assess the psychosocial adjustment of children affected by HIV/AIDS in the eastern part of Ghana. Method: Four groups of children (children who lost their parents to AIDS; children who lost their parents through other causes; children living with HIV infected; alive parents and the comparison children who were from the same community but did not have HIV/AIDS-related illness or death in their families) were interviewed on depressive symptoms; prosocial behaviours; hyperactivity; conduct and peer problems using the Strengths and Difficulties Questionnaire (SDQ). Results: Orphans in general and children living with HIV-infected parents consistently demonstrated poorer psychosocial adjustment than comparison children in the same community. Conclusion: The findings underscore the urgency and importance of culturally and developmentally appropriate intervention efforts targeting psychosocial problems among children affected by AIDS and call for more exploration of risk and resilience factors; both individual and contextual; affecting the wellbeing of these children

The Impact of Organisational Culture on the Adaptation of Newly Employed Nurses to Work Environment

Usually newly employed nurses find adjusting to a work setting a challenging experience.Their successful adaptation to their work situation is greatly influenced by the socialisation process inherent in the organisational culture. The newly employed nurse often finds that the norms are unclear; confusing and restrictive. The purpose of the study was to examine the impact of organisational culture on the adaptation of newly employed nurses to the work environment. A descriptive quantitative survey was employed to explore the constructs of organisational culture that have a positive or a negative impact on the adaptation of newly employed nurses to the work setting. Constructs such as conflict resolution; employee participation; human resource orientation; goal clarity; identification with the organisation; locus of control and management style were examined. Participants expressed their views as to what constructs of organisational culture had a positive or a negative impact on their adjustment to the work settings. For the culture to serve its function it must be perceived as correct and valid and if it is perceived that way; it automatically follows that it must be taught to newcomers