An investigation of the patterns and outcomes of Electroencephalographic (EEG) recording requests in the management of neuropsychiatric disorders in a teaching Hospital in Nigeria.

OBJECTIVE: To evaluate the relevance of Electroencephalography (EEG) in the management of various neuropsychiatric conditions in University of Ilorin Teaching Hospital (UITH), Ilorin. BACKGROUND: EEG is still relevant in the diagnosis and management of patients with seizure disorders and extends to other neuropsychiatric conditions. However, very few studies have examined the use of EEG in developing countries, including Nigeria. METHODS: The EEG records of 154 patients between January 2012 and December 2012 were reviewed. EEG unit's records, including EEG request forms and EEG reports were examined. Socio demographic data, clinical data and the neurologist's comments on the EEG recordings were extracted and recorded on the proforma form. RESULTS: A total of 142(92.2%) of the patients out of 154 had complete records and were studied. Majority (84.5%) of the patients were below the age of 30 years. Various types of seizure disorders accounted for 80% of the provisional diagnosis. The EEG diagnosis based on the interpretation of the EEG records showed that 96 (67.6%) of the patients had normal records. CONCLUSION: EEG still plays a very important role in the investigation of neuropsychiatric conditions especially epilepsy in developing countries. EEG facilities should be readily available.

Prevalence and clinical implications of psychopathology in adults with epilepsy seen in an outpatient clinic in Nigeria.

BACKGROUND: The psychopathological and clinical characteristics of adult patients with epilepsy attending our neurology clinic were evaluated to determine prevalence of psychopathology and its associated factors towards improving services and initiating collaborative care which is currently nonexistent. METHODS: The study was a two-stage procedure conducted over 1 year using the General Health Questionnaire in the first stage and Schedule for Clinical Assessment in Neuropsychiatry in the second stage. Diagnosis of psychiatric disorders was based on International Classification of Diseases: 10th Revision criteria. RESULTS: Sixty-three patients were interviewed. Mean age was 34.43 ± 13.7 years; more than half of the patients had less than one seizure episode per month. Fourteen patients (22.2%) had partial epilepsy; 40 (63.5%), generalized; and 9 (14.3%), unclassified seizures. The rate of psychiatric morbidity was found to be 28.6%. Depressive disorders were the most common (66.7%), followed by psychotic disorders (11.1%), anxiety disorders (11.1%) and dementia (11.1%). Psychopathology was more common in women (P=.007), those older than 40 years (P = .038) and those with partial epilepsy (P = .017). CONCLUSION: About one third of patients with epilepsy studied had undetected and untreated psychopathology. Our neurology clinic urgently needs currently nonexistent collaborative care involving neurologists, psychiatrists and primary care physicians in order to improve the mental health of the patients with epilepsy.

Mental health of doctors in a tertiary hospital in Nigeria.

INTRODUCTION: Doctors are vulnerable to psychiatric morbidity as a result of their busy schedules and multiple role obligations. Yet, they often don't admit they have mental health problems nor are they readily subjected to mental health evaluation by their colleagues due to fear of labeling and general stigma. METHODS: A cross-sectional survey of doctors in the service of University of Ilorin Teaching Hospital, Ilorin, Nigeria was done using a socio-demographic questionnaire and the twelve items General Health Questionnaire (GHQ-12) using a cut-off point of 3 to indicate possibility of psychiatric disorder (GHQ-12 positive). Non-parametric analysis and regression test of factors associated with psychiatric morbidity was done using SPSS. Level of significance was set at 0.05 p-value. RESULTS: Two hundred and forty one doctors representing 68.9% of the doctors participated in the survey. The point prevalence of psychiatric morbidity among the doctors using the GHQ-12 was 14.9%. Being married, non-participation in social activities and perception of work load as being "heavy" were significantly associated with psychiatric morbidity (p-value < 0.05). CONCLUSION: The prevalence of psychiatric morbidity among doctors at the University of Ilorin Teaching Hospital was higher than the general population prevalence. Measures to lessen the negative effect of marriage and the perceived heavy work load on mental health of doctors, such as provision of recreational facilities within the hospital and encouragement of doctors' participation in social activities are advanced.

Psychiatric morbidity in mothers of children attending primary care facility in Ilorin, Nigeria: drawing attention to those affected concurrently with their children.

OBJECTIVE: To determine the prevalence of psychiatric morbidity among mothers of children attending a primary care clinic in University of Ilorin Teaching Hospital as precursor to developing an intervention programme. METHOD: WThree hundred fifty mothers of children aged 7-14 years were screened with the 12-item General Health Questionnaire for psychiatric morbidity. As part of the larger study, their children were screened for psychiatric disorders with the parents' version of the Child Behaviour Questionnaire, and a subsample of 157 mother/child dyad had second-stage interview with the children's version of the Schedule for Affective Disorders and Schizophrenia to determine psychiatric morbidity in these children. RESULTS: Twenty-eight out of 350 mothers (8%) had probable psychiatric morbidity. Mothers with psychiatric morbidity were significantly more likely to have children with Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition psychiatric diagnosis (8 of 28, P=0.011), experience parenting difficulties with some of their children (13 of 28, P=0.000) and have poor husband support for the care of their children. CONCLUSION: The presence of psychiatric morbidity in mothers may require that other members of the family especially the children be screened for psychiatric disorders particularly when there are parenting difficulties and poor spousal support; in this way primary prevention or control can effectively be carried out.