The association between intimate partner violence, psychiatric morbidity amongst pregnant women and partner alcohol use in southern Nigeria

Background: Intimate partner violence (IPV) against women is common, although prevalence and correlates amongst pregnant women in developing countries are poorly researched. Aim: To identify the magnitude of IPV, and its relationship with psychiatric morbidity and partner alcohol use. Setting: This study was conducted among women receiving routine ante-natal care at a secondary level healthcare facility in southern Nigeria. Methods: A cross-sectional descriptive study was conducted by recruiting pregnant women (n = 395) attending the Ante-Natal Clinic of the Central Hospital, Benin-City, Edo State, Nigeria, between August 2015 and February 2016 and undertaking face-to-face interviews utilising a socio-demographic questionnaire, the Composite Abuse Scale and the 20-item Self-reporting Questionnaire. Results: Past 12-month prevalence of IPV was 24.8%, with emotional abuse being the commonest type (89.8%). Forty-six participants (11.6%) screened positive for probable psychiatric morbidity. Predictors of IPV included partner alcohol use in the past 12 months (adjusted odds ratio [aOR]: 2.67; 95% confidence interval [CI]: 1.16­6.16; p < 0.02), having a psychiatric morbidity (aOR: 2.53; 95% CI: 1.27­5.04; p < 0.01), being single (aOR: 2.12; 95% CI: 1.25­3.58; p < 0.01) and multiparous (aOR: 2.5; 95% CI: 1.43­4.38; p < 0.001). Conclusion: Intimate partner violence was common amongst pregnant women in Nigeria. Identified modifiable risk factors can be targets for screening and intervention for women in these settings

Comparative assessment of quality of life of patients with schizophrenia attending a community psychiatric centre and a psychiatric hospital

Background: Over the past few decades, there has been an emphasis on the de-institutionalisation of psychiatric care with a focus on community care. With Quality of Life (QoL) as an outcome measure, this study compared the QoL of patients with schizophrenia attending a psychiatric hospital and a community psychiatric centre. Design: This was a cross-sectional study in two psychiatric facilities Methods: Data were obtained through a socio-demographic and clinical questionnaire; the QoL was assessed with the WHOQOL-BREF and patient satisfaction with care with CPOSS. Total and domain scores of WHOQOL-BREF for each group were calculated and compared with each other and other group characteristics. Diagnosis of schizophrenia was based on ICD-10.Results: Participants from the two centres did not differ significantly on any of the socio-demographic characteristics measured. Similarly, there was no significant difference in their overall mean WHOQOL-BREF scores as well as the mean WHOQOL-BREF of domain scores. However, the married and females from both centres significantly had higher mean WHOQOL-BREF scores than their male counterparts. Patients in remission for more than two years or those on a single type of medication (either oral or depot preparation) from both centres significantly had higher mean WHOQOL-BREF score compared with those who had less than two years of remission or on both oral and depot preparations. Conclusion: Overall QoL of patients managed at the two centres was comparable, with similar socio-demographic as well as clinical variables influencing QoL. This suggests that patients with schizophrenia can be well managed at community psychiatric centres

Anxiety disorders: Psychiatric comorbidities and psychosocial stressors among adult outpatients

Background: Anxiety disorders are the most prevalent class of lifetime mental disorders according to South African research. However, little is known about the prevalence of factors that might complicate treatment among adults in a psychiatric outpatient setting. Aim: To explore the psychiatric comorbidities and psychosocial stressors among a population of adults treated for anxiety disorders at the outpatient unit of a tertiary psychiatric facility in Bloemfontein. Methods: In this retrospective cross-sectional study, clinical files of all mental healthcare users receiving treatment were reviewed to identify those with a current or previous diagnosis of one or more of the following anxiety disorders: generalised anxiety disorder (GAD), panic disorder, social anxiety disorder (SAD) and agoraphobia. Results: Of the 650 available records, 103 (15.8%) included at least one anxiety disorder. Of those, 65.1% had GAD, 34.0% had panic disorder and 29.1% had SAD. Agoraphobia was diagnosed in 14.6% of patients almost exclusively as comorbid with panic disorder. Additional psychiatric disorders were present for 98.1% of patients and 36.9% had multiple anxiety disorders. The patients had a history of relational problems (64.1%), educational and occupational stressors (55.3%), abuse and neglect (28.2%), other problems related to the social environment (24.3%) and self-harm (23.3%). Conclusion: Clinical practice should take the high rates of comorbidity into account and the importance of integrated substance-related interventions in mental healthcare settings is clear. Diagnostic practices regarding agoraphobia without panic, and the comorbidity of anxiety and personality disorders should receive further attention. Clinicians should be aware of the potential impact of the frequently reported psychosocial stressors

Neuropsychological Diagnostics in Ethiopia - Challenges and Chances among Considerations Regarding Differential Diagnosis (Literature Overview)

"Background Neuropsychological tests can provide crucial information regarding the consideration of psychiatric differential diagnosis. This is especially important in developing countries like Ethiopia where advanced imaging is not widely available. Methods A detailed literature search was conducted using the search engines Pubmed; Science Direct; Web of Science and Google Scholar from February 2013 until May 2014. Selecting the identified studies pragmatically depending on the content; twenty-six studies were included. Results The administration of tests developed in Western-European settings to the African culture presents enormous challenge. Among these are especially the influence of low level of literacy; familiarity with the testing material; cultural aspects regarding social behavior and sense of time; cultural differences regarding cognitive functions and lack of norms. At the same time; there are opportunities for different fields of application; especially when considering the diagnosis of dementia and in the assessment of frontal lobe lesions. Assessment of cognitive flexibility appears to be an important way to differentiate between affective disorders and schizophrenia. Conclusions In conclusion; we suggest a ""basic set of neuropsychological tests"" for application in psychiatric facilities in low income countries like Ethiopia; which mostly includes nonverbal tests. By using these tests; some of the challenges found during the literature search can be overcome. Additionally; they might provide extra information for diagnostic issues. However; they might have to be adapted to the Ethiopian culture."

Chronic Fatigue Syndrome: Diagnosis and Treatment

Chronic fatigue syndrome (CFS) refers to marked and prolonged fatigue; for which no indentifiable cause can be found. Despite the presence of extensive symptoms; diagnosis is made when there is profound fatigue; lasting for a duration of six months; or longer. CFS is frequently seen in association with psychiatric illnesses;such as depression and anxiety; but has not been shown to be casually related to any particular psychiatric disease

Psychiatric features in perpetrators of homicide-unsuccessfulsuicide at Weskoppies Hospital in a 5-year period

Background. In the absence of medical literature reporting on homicide-unsuccessful-suicide (HUS) cases in which the perpetrator is referred for forensic psychiatric observation present an opportunity to explore psychiatric features pertaining to the event.Objective. To identify possible contributing psychiatric features in HUS cases.Method. A retrospective; single-centre; descriptive study was conducted; in which were reviewed clinical records of HUS subjects referred for observation to Weskoppies Hospital from December 2005 to January 2011. Socio-demographic and psychiatric information was obtained. Results. Nine cases were reviewed. The median age of the subjects was 29 years and 7 subjects were male. Five cases involved family members. Cases involving couples demonstrated male subjects and cases involving filicide demonstrated female subjects. Only 1 case involved the use of a firearm. At the time of the incident; 4 of the cases had no psychiatric diagnosis but notable interpersonal difficulties. Psychotic disorders were diagnosed in 3 subjects; a depressive disorder in 1 subject and a depressive and anxiety disorder in 1 subject.Conclusion. Subjects commonly used less lethal methods than shooting. The high rate of psychiatric disorders diagnosed is in keeping with court referrals occurring when a mental illness is suspected. Some cases may require specialised probing before psychosis becomes apparent. Identification of psychosocial stressors and failure of coping mechanisms during periods of strife within an intimate relationship may be a focus of future research in homicide-suicide cases. Separation should possibly be investigated as an independent factor which promotes the interpersonal difficulty associated with homicide-suicide

Exploring the Perceptions of Psychiatric Patients Regarding Marijuana Use

There is limited understanding on marijuana use by psychiatric patients; specifically with regard as to why they continue to smoke marijuana despite the negative consequences; such as readmittance to psychiatric hospitals following marijuana-induced psychosis. It is; therefore; important to understand why psychiatric patients continue to use marijuana; despite experiencing its negative effects. The purpose of this study was to explore and describe the perceptions of psychiatric patients with regard to marijuana use in Potchefstroom; North West Province; as well as to formulate recommendations for nursing education; nursing research and nursing practice; with the aim of reducing the readmission of psychiatric patients following marijuana-induced psychosis. A qualitative; exploratory; descriptive and contextual research design was followed in order to give 'voice' to the perceptions of psychiatric patients about marijuana use. Purposive sampling was utilised to identify participants who complied with selection criteria. The sample size was determined by data saturation; which was reached after 10 individual interviews with psychiatric patients. Unstructured individual interviews were utilised to gather data after written approval from the Ethics committee of the North-West University (Potchefstroom Campus); North West Provincial Department of Health; the clinical manager of the psychiatric hospital where data were collected; as well as from the psychiatric patients. The co-coder and the researcher analysed the data independently. The findings of this study include perceptions of psychiatric patients on the use of marijuana; the negative effects of marijuana use; marijuana use and mental illness; and quitting marijuana. Recommendations were formulated for nursing education; nursing research as well as for nursing practice

Cannabis publication analysis using density-equalising mapping and research output benchmarking

Background. Cannabis has been a topic of political and medical controversy in many countries over the past century. Although many publications on this topic are available, there is currently no comprehensive evaluation of global research activities in the field. Objective. This study was conducted in order to provide a quantitative and qualitative analysis of the worldwide research output on cannabis. Methods. In a quantitative approach, items concerning cannabis published between 1900 and 2008 were retrieved from the ISI Web of Science databases developed by the Thompson Institute of Scientific Information and analysed using scientometric methods. In a second step, research fields of growing interest were identified. Results. We found that publications on this topic increased during the late 1960s, as well as during the period 1990 - 2008. We noted that South Africa was one of the countries with a high research output; having published numerous articles on cannabis. A comparison of cannabis with other drugs (e.g. alcohol, tobacco, cocaine and heroin) showed that in relation to the proportion of respective drug users, cocaine and heroin are overly represented in terms of research output. When analysing the main subjects of the publications; psychiatry was prominent, especially with regard to research on psychosis. Conclusion. There is increasing interest in research on cannabis. The research only partially reflects the drug's importance with regard to number of users

Attitudes towards psychiatry of undergraduate medical students at Bayero University, Nigeria

Background. This study determined and compared responses of 5th- and 6th (final)-year medical students on their attitudes to psychiatry as a profession. Also elicited were their choices of area of future medical specialisation. Method. A prospective and cross-sectional study using an adapted 27-item self-administered questionnaire to obtain responses from 91 5th- and 6th-year medical students at Bayero University, Kano, Nigeria. Results. More than 60% of the students' first choices for future specialisation were surgery, obstetrics/gynaecology or internal medicine. Psychiatry was the first preference for less than 2%. More than 75% of the students' views on the overall merits and efficacy of psychiatry were positive, although they felt that psychiatry had low prestige and status as a profession. In addition, the same proportion considered that psychiatry was scientific, making advances in the treatment of major mental disorders, and helpful in liaison practice. More than 50% stated that psychiatry would not be their choice of last resort for residency education and the same proportion felt that friends and fellow students rather than family members would discourage them from specialising in psychiatry. More than 50% would feel uncomfortable with mentally ill patients, felt that psychiatry would not be financially rewarding, and did not think that psychiatrists abuse their legal power to hospitalise patients. Attitudes of the two groups of students to psychiatry as a profession were not significantly different (p>0.05). Conclusion. A clinical clerkship in psychiatry did not influence the students' choice of future specialisation

Psychiatric In-Patients' Experience of Being Secluded in a Specific Hospital in Lesotho

This qualitative; explorative; descriptive and contextual study was undertaken to explore and describe the experiences of psychiatric in-patients who are secluded in a specific hospital in Lesotho. Evidence about the rationale and appropriate use of seclusion as well as promotion of mental health in secluded patients has been expressed and docu- mented in the literature. The mental health legislation of Lesotho does not specifically address seclusion of psychiatric in-patients. This research is crucial because it has not been conducted before and information pertaining to it is limited. Purposive sampling was used. Data were generated through eleven (11) individual semi-structured phenome- nological interviews. One central open question was posed to the participants. Patients were interviewed until saturation was reached. Field notes were taken. All interviews were audio taped and transcribed verbatim. Tesch's (in Creswell; 1994:142) method of open coding was used to analyse data. Results where described; pertaining to the categories identified. The main categories were: (1) the experience of being in a prison; (2) seclusion experienced as a punishment; which created an environment where human rights violations were experienced; (3) personnel factors leading to an experience of not being supported and cared for; and (4) emotional responses to the seclusion experience. A literature control followed the description of the results

Explorations paracliniques en pratique psychiatrique ambulatoire

Dans la presente etude retrospective; nous nous sommes interesses aux explorations para cliniques en pratique psychiatrique ambulatoire.Notre objectif a apprecie la place des explorations paracliniques dans la prise en charge des affections psychiatriques chez 556 patients; d'age compris entre 16 et 55 ans; vus en consultation au DHM de INSP dans la periode du 10f Janvier 2003 au 31 Decembre 2004.Il ressort de notre etude les resultats suivants*61;87pour cent des patients ont un age compris entre 18 et 34 ans; les patients ages de 45 a 55 ans ne representent que 20;51pour cent.*Une predominance feminine (53;60pour cent) avec une sex-ratio de 1;15. La majorite des patients (54;5pour cent) est sans revenu.*55;76pour cent des patients ont ete adresses par leurs parents.*Les antecedents psychiatriques personnels ont ete retrouves dans 75;90pour cent des cas.*L'alcoolisme est le type de conduite addictive le plus frequent (38;06pour cent).*65;83pour cent des patients ont eu un debut progressif des troubles psychiatriques.*Concernant les diagnostics evoques; les troubles de l'humeur predominent (43;53pour cent); suivis des troubles psychotiques brefs (27;34pour cent); des troubles psychotiques chroniques (21;04pour cent) et des troubles organiques (7;91pour cent).*L'abord des explorations paracliniques revele que:La majorite des patients n'a pas beneficie d'explorations para cliniques (65;71pour cent).L'EEG est la plus realisee (47;84pour cent); suivie de la biologie (36;86pour cent).66;66pour cent des patients ont eu un controle de leur bilan au moins 7 mois apres la conduite therapeutique.Les explorations paracliniques ont ete demandees dans le cadre d'un suivi normal (64;14pour cent) et suite a une pathologie organique associee (28;79pour cent).*En tenant compte de l'evolution therapeutique; on a observe:Une bonne observance de leur traitement dans 81;65pour cent des cas.Une evolution favorable de leur symptomatologie dans 89;93pour cent des cas

The neuropsychiatry of brain tumours

Every psychiatrist who has worked in the clinical field for some time will be able to relate a story of a patient who presented with psychiatric symptoms but eventually turned out to have a brain tumour. We all fear that someday we will misdiagnose a brain tumour and therefore fail to save a patient's life. The purpose of this article is to give a brief outline of the important clinical issues related to brain tumours and psychiatry

Approche epidemiologique et clinique des troubles psychiatriques des personnes agees : a propos de 464 cas recenses au DHM de l'INSP du 1er Janvier 1999 au 31 Decembre 2003

L'etude des personnes agees ayant consultees au DHM du 1er janvier 1999 au 31 decembre 2003 montre une predominance des femmes (65;52pour cent) soit un sexe ratio de 1;9 femmes pour un homme. Ces sujets ont le plus souvent entre 55 et 65 ans; resident majoritairement a Abidjan (63;15pour cent) et sont sans profession (59;70pour cent). Ces personnes agees sont; dans la plupart des cas (73;28pour cent); adressees par leur famille; cependant; apres plus de six mois de latence (35;34pour cent). Le tableau clinique est le plus souvent domine par des troubles de la pensee (41;81pour cent) suivis par les troubles instinctuels (39;22pour cent). La pathologie organique constitue le diagnostic le plus frequent (36;22pour cent) avec les syndromes dementiels qui y sont predominants (86;90pour cent). Concernant le traitement; les neuroleptiques sont les psychotropes les plus prescrits (58;53pour cent) suivis par les antidepresseurs (28;38pour cent) et les anxiolytiques (25;43pour cent). Dans certains cas; d'autres classes therapeutiques sont associees. Il s'agit; par ordre decroissant de frequence des oxygenateurs cerebraux (19;61pour cent); des antiischemiques (11;21pour cent) et des complexes vitaminiques (2;37pour cent)

Les aspects epidemiologiques des maladies mentales a l'hopital psychiatrique de Bouake sur dix; 10; annees 1989-1998

Nous avons procede a l'etude des nouvelles consultations a l'hopital psychiatrique de Bouake du 1er Janvier 1989 au 31 Decembre 1998 et identifie les nouveaux consultants selon le sexe; l'age; la situation matrimoniale; la profession et le diagnostic retenu. Les activites du service se revelent importantes : 4105 nouvelles consultations ont ete recensees sur la periode d'etude . L'echantillon qui est de 3828 nouvelles consultations exploitees est representees en majorite par : - Les sujets de sexe feminin (54;3 pour cent) contre 45;7 pour cent pour le sexe masculin; - la tranche d'age comprise entre 16 et 25 ans (31;2 pour cent); - les menageres (31;7 pour cent) puis les eleves et les etudiants (14;7 pour cent); - les maries (47;2 pour cent); - les syndromes anxieux; premiere pathologie des consultants (29;21 pour cent). Ces resultats doivent susciter une reflexion permettant une amelioration de l'accueil avec etoffement en personnel et activites de formation continue afin de maintenir ou d'ameliorer la qualite de soins. Mais surtout de promouvoir une action preventive en matiere de psychiatrie

Place des pathologies mentales au conseil de sante de la Cote d'Ivoire. Bilan de 10 annees d'activite : de janvier 1989 a decembre 1998

Le Conseil de Sante de la Cote d'Ivoire a ete mis en place le 1er avril 1965 arrete no12 SP. CAB et est charge d'examiner et d'emettre son avis sur : -Les demandes presentees par les fonctionnaires et agents de l'etat au sujet des Conges de maladie; conges de convalescence; conges de longue duree; changements de position administrative pour raison de maladie. -Les demandes d'evacuation sanitaire hors de la Cote d'Ivoire; -Les demandes de cure thermale. Cette etude a pour objet d'apprecier la place qu'occupent les sujets consultant pour des motifs d'ordre psychiatrique. En effet la frequence des pathologies mentales est elevee; c'est ainsi que sur 10 ans (de janvier 1989 a decembre 1998); les services de psychiatrie ont adresse 1342 sur les 5629 demandes repertoriees au Conseil de Sante soit 23;8 pour cent ;les services de Pneumophtisiologie et de Neurologie ayant respectivement 20;2 pour cent et 12;4 pour cent. Les sujets de sexe masculin representent 70;9 pour cent des consultants et les professions d'enseignants (instituteurs; professeurs du secondaire et du superieur) 56;6 pour cent avec un taux de 41;6 pour cent (sur les 5629 demandes) pour les seuls instituteurs. Les sujets de sexe masculin represente 70;9 pour cent des consultants et les professions d'enseignants (instituteur; professeurs du secondaire et du superieur) 56;6 pour cent avec un taux de 41;6 pour cent(sur les 5629 demandes) pour les seuls instituteurs. Les diagnostics de psychiatrie les plus frequents sont les Etats psychotiques chroniques a savoir schizophrenie; paranoia; psychose hallucinatoire chronique avec 37 pour cent suivi de la depression avec 36;5 pour cent. Les decisions finales du conseil de Sante a savoir maintien ou non de l'activite professionnelle sont en faveur du maintien avec 89;7 pour cent des 5629 demandes avec cependant 13;3 pour cent des dossiers non traites. Les sujets de sexe feminin representent les taux les plus eleves de demandes de conge de maladie courte duree(grossesse a risque)et aussi un taux important des patients adresses par les services de cancerologie 96;2 pour cent (contre 30;8) d'hommes sur les 65 cas .Ce travail revele la meconnaissance du statut et des objectifs du Conseil de Sante par les fonctionnaires et aussi leurs superieurs hierarchiques ses limites sont imprecises et ses decisions vont permettre d'eviter des sanctions disciplinaires

Pathologies psychiatriques en milieu hospitalier feminin. A propos de 146 cas colliges a l'hopital psychiatrique de Bingerville

"Les deux pavillons de femmes de l'H.P.B. ont ete baptises en septembre 1998 Pavillon ABHE ANTOINE du nom du premier psychiatre ivoirien qui y a exerce comme medecin chef. Cette etude retrospective a porte sur 146 nouveaux cas hospitalises en 1997. Ce sont des patients adultes jeune (76;07 pour cent); de religion chretienne (66;4 pour cent); sans emploi (67;8 pour cent) et residant generalement a Abidjan (65;8 pour cent). La demande de soins a ete surtout formulee par leur famille (74;7 pour cent) et pour les 3 principaux motifs suivant : l'agitation psychomotrice; l'incoherence des propos; I'agressivite. Les pathologies psychiatriques qui s'exprimaient ainsi ont ete identifiees selon les criteres de OMS (CIM 10) comme etant principalement : la schizophrenie et les troubles delirants (58;9 pour cent); les troubles affectifs (21;9 pour cent); les troubles mentaux organiques (8; 2 pour cent). Ainsi les troubles mentaux ""origine physiologique (psychose puerperale) specifiques a cette population feminine ne representent que 2; 1 pour cent. Les activites qui Sont menees dans ce pavillon sont les memes que celles de l'H.P.B dont il fait partie : consultations; soins hospitaliers; formation; recherche. Le volume hospitalier du pavillon a represente en 1997 33;6 pour cent du volume total de l'H.P.B. Les problemes que rencontre le Pavillon ABHE ANTOINE ne lui sont pas specifiques et meritent que les autorites competentes y portent un interet particulier."