Functional status and its associated factors in Nigerian adults with serious mental illnesses

Patients with serious mental illness may be less likely to achieve functional goals than the general population. Assessment of the functional impact of the illness is useful to determine severity of illness, evaluate remission, and achieve optimal treatment success. The aims of this study are to determine and compare the prevalence of low functional status among outpatients with major axis 1 psychiatric disorders, assess the risk factors for low functional status, and determine the proportion of the variance in low functional status explained by low self-esteem and non-adherence to medication. A descriptive cross-sectional study was conducted among 308 outpatients of the psychiatric unit of a tertiary hospital. The Global Assessment of Functions (GAF), Morisky Medication Adherence Scale (MMAS-8) and the Rosenberg's Self-esteem Scale were used to collect data, which were analyzed using version 20 of SPSS. Level of statistical significance was set at 5% (P < 0.05). The overall prevalence of low functional status was 40.6%. Patients with schizophrenia had the highest prevalence of low functional status (53.4%). Educational attainment, employment status, self-esteem, medication adherence, and comorbidity had significant association with functional status. Poor medication adherence had the largest relative contribution (35.4%) to the variance in functional status, while self-esteem had an insignificant relative contribution of 3.4%. An appreciable proportion of the patients in this study had low functional status with more schizophrenic patients having impairment than patients with mood disorders. Poor medication adherence, among other variables, contributes significantly to low functional status. Physicians should give as much attention to functional recovery as they give to symptom resolution in the management of psychiatric patients

Les manifestations psychiatriques chez les personnes vivant avec le VIH au Mali

Les troubles psychiatriques au cours de l'infection a VIH ont un impact negatif sur la prise en charge des autres co-morbidites et peuvent constituer en eux-memes une cause de mortalite. Le but de notre etude etait d'evaluer la prevalence des troubles psychiatriques au cours de l'infection par le VIH dans les services de maladies infectieuses et de psychiatrie du CHU du Point G. Nous avions realise une etude prospective et descriptive allant du 1er Juillet 2004 au 31 Octobre 2005 portant sur 166 patients. Les cas d'infection a VIH ont ete definis sur la base de la positivite de la serologie VIH par au moins 2 tests rapides associes ou non a des signes cliniques du SIDA selon la classification CDC. Toute perturbation des fonctions superieures etait consideree comme manifestations psychiatriques. Le sexe feminin etait majoritaire avec un sex- ratio de 0;9. La tranche d'age de 36 a 41 ans etait la plus touchee. Les menageres representaient 36;7de l'echantillon et les maries representaient 64;5. La prevalence des troubles psychiatriques etait de 58;9. Les troubles ont ete domines par la depression (45;8) suivis du syndrome confusionnel 31;9et de l'epilepsie 7;8. Les sujets etaient infectes par le VIH-1 dans 93;4des cas. La survenue des troubles psychiatriques etait inversement proportionnelle au taux de CD4. La letalite etait tres elevee soit 56

Ageing and mental health resources for older persons in the African region of the World Health Organization

Africa is a region where a demographic transition from high child mortality and low life expectancy; to low child mortality and high life expectancy is only just beginning.Nevertheless; some countries already have a growing number of persons over the age of 60 - a number that is likely to increase rapidly. As a consequence; the number of older persons with mental disorders is likely to increase. To better understand the organisation of care for older persons; data are being collected to reduce the imbalance between 'disease information' and 'resource information' - information that addresses older persons' needs in terms of mental health care.This review presents some results from the continent. Mental health problems among older adults are still not a public health priority in Africa; but careful examination of each country nevertheless reveals certain specificities; such as divergent life expectancy and different values regarding ageing. The authors present some recommendations for the development of carefor old persons with mental disorders; based on the general recommendations made by the World Health Organization (WHO) in the World Health Report 2001 (WHR 2001); and by the WHO and the World Psychiatric Association (WPA) in some consensus statements on psychiatry of the elderly

Femmes et psychiatrie

Les activites regulieres de prise en charge au niveau du pavillon de consultations psychiatriques du Centre Hospitalier de Fann peuvent constituer un repere en matiere de pathologie psychiatrique de la femme au Senegal. Une etude portant sur l'annee 1990 essaie de mettre en evidence cette pathologie et d'en faire une approche epidemiologique et psyhopathologique. Les resultats obtenus et leurs commentaires peuvent etre une source d'eclairage non negligeable dans ce domaine complexe de la medecine qu'est la psychiatrie