Substance Use Disorders and Antisocial Personality Disorder among a Sample of Incarcerated Individuals with Inadequate Health Care: Implications for Correctional Mental-Behavioural Health and Addiction Services.

Epidemiological estimates of substance use disorders (SUD) are critical for the planning of evidence-informed intervention and services. In this study, 250 incarcerated individuals in Nigeria were interviewed with the Mini International Neuropsychiatric Inventory (MINI) to diagnose SUD and antisocial personality disorder (ASPD). Most of the participants were males (97.6%), and the mean age was 35.4 (SD=13.5) years. Substance use disorder and ASPD were prevalent in 57.6% and 11.2% of the participants, respectively. Of those diagnosed with SUD, 35.2% and 22.4% had poly-SUD and mono-SUD respectively. Psychotic and dependence syndromes involving cannabis misuse were the most prevalent poly-SUD, and mono-SUD was characterized by alcohol, nicotine, and opioid dependence syndromes. Substance use disorder was more likely in participants charged with robbery and convicted, while ASPD was associated with prior and long-term imprisonment. There is a need for effective integration of treatment for ASPD/SUD into correctional mental health services in settings with inadequate health care using an appropriate model and a viable strategy.

A comparative study of perceived burden in parent caregivers of adolescents with epilepsy in a resource-restricted setting: Investigating the explanatory factors of perceived burden.

OBJECTIVE: Parent caregivers often play vital roles in the care of adolescents with epilepsy (AWE) in resource-restricted settings; however, little is known about the burden borne by these parents. This study investigated the burden perceived by parents of AWE and described the explanatory factors. METHODS: An equal number (n = 121) of age- and gender-matched parent caregivers of AWE (cases) and parents of adolescents with sickle cell disease (comparison group) were interviewed with the Parent Illness Intrusiveness Rating Scale to assess disruptions in their relationships and lifestyle. Parents of AWE were assessed for psychological distress with the 12-item General Health Questionnaire, and AWE were interviewed with the Hospital Depression-Anxiety Scale. RESULTS: The majority of the cases and the comparison group were mothers (76%), with mean (SD) ages of 44.11 (SD = 6.92) versus 43.59 (SD = 6.39) years, respectively. The prevalence rate of psychological distress in cases was 38%, and depressive-anxiety symptom was prevalent in 39.7% of AWE. The level of perceived burden was significant in all parent caregivers, albeit higher in cases relative to the comparison group across multiple domains, including relationship/personal development, intimacy, instrumental and global. A high level of burden in parents of AWE was predicted by a poor family financial and material support to the adolescents, increased contact hours with adolescents, psychological distress in the parent caregivers, and anxiety-depressive symptoms in AWE after controlling for cofounders. CONCLUSION: The study findings underscore the need for psychosocial support to bolster resilience and adaptive coping styles in parents of AWE, particularly in resource-restricted settings. A culturally sensitive interdisciplinary blueprint of locally viable actions model for psychosocial support for parent caregivers of AWE is strongly suggested. Future studies are indicated to shed more light on the modifiable risks of perceived burden, and the effectiveness of psychosocial interventions in parents of AWE.

Psychological distress and sleep problems in healthcare workers in a developing context during COVID-19 pandemic: Implications for workplace wellbeing.

BACKGROUND: Emotional wellbeing of healthcare workers is critical to the quality of patient care, and effective function of health services. The corona virus disease-2019 (COVID-19) pandemic exerted unique physical and emotional demands on healthcare workers, however little is known about the emotional wellbeing of healthcare workers during the COVID-19 pandemic in resource-restricted settings. This study investigated the prevalence of psychological distress, and sleep problems in healthcare workers in a COVID-19 referral hospital in Nigeria. METHODS: A total of 303 healthcare workers were interviewed with the 12-item General Health Questionnaire (GHQ-12) to evaluate psychological distress, and the Pittsburgh Sleep Quality Index (PSQI) to assess multidimensional aspects of sleep, including quality, latency, duration, habitual efficiency, disturbances, use of sleeping medications and daytime dysfunction. RESULTS: The participants were mostly males, 183(60.4%) and mean age was 38.8(SD = 8.9) years. Most of the participants were married (70.3%), had spent less than 10 years in service (72.9%), and had no medical comorbidity (92.1%). The prevalence of psychological distress was 23.4%, and six in every ten participants reported sleep problems. The largest proportion of participants reported difficulty in sleep latency (81.5%), duration (71.3%), and daytime dysfunction (69.6%), while approximately one third (32%) each reported using sleep medication, and had difficulty with sleep quality. Psychological distress was inter-related with poor sleep problems (p = 0.001; effect size = 0.2). CONCLUSION: The prevalence rates of psychological distress and sleep problems during the COVID-19 pandemic were several folds the rates previously reported in similar contexts. Preventative psychosocial support services for healthcare workers are indicated. The creation of a culturally-sensitive interdisciplinary blueprint for locally-viable actions model are strongly suggested ahead of future emergency situations.

Psychiatric Morbidity among Incarcerated Individuals in an Underserved Region of Nigeria: Revisiting the Unmet Mental Health Needs in Correction Services.

While epidemiological description of psychiatric morbidity can promote evidenceinformed mental health services, there is a paucity of such evidence among incarcerated individuals in prisons with underserved healthcare. We evaluated 250 incarcerated individuals detained in an underserved prison in north-western Nigeria with the Mini International Neuropsychiatric Inventory (MINI). Predominantly, study participants were men (97.6%) and the mean age was 35.4 (SD=13.5) years. The majority of the incarcerated individuals (81.2%) were awaiting trial, the most common crime was armed robbery (38.8%), and 16.4% of participants were recidivists. The prevalence of psychiatric morbidity was 47.4%, with major depression being the most common diagnosis (23.2%). The majority (92.8%) had no prior contact with psychiatric treatment. Being single, employed, and lacking prior psychiatric treatment were independently associated with psychiatric morbidity (R2=0.27). These findings underscore the need for better investment in correctional mental health services. Multi-pronged efforts with multisectoral collaboration between the government and other stakeholders to develop scalable interventions are advocated.

Emotional distress among parent caregivers of adolescents with sickle cell disease: Association with patients and caregivers variables.

Evidence suggests that impairment in caregiver wellbeing can alter the quality of care in children with sickle cell disease. We examined 121 parent caregivers of adolescents with sickle cell disease for emotional distress and disruptions to caregiver lifestyle and interests. Participants were predominantly mothers 92(76%) with mean age, 43.59 (SD = 6.39) years. Four in every ten caregivers had emotional distress, and this was predicted by frequent hospital attendance and disruptions in caregiver lifestyle, relationships, and interests. Psychosocial support to promote resilience and adaptive coping-styles to deal with the stress from unforeseen crises, frequent hospital visits, and lifestyle disruptions are indicated to improve caregiver wellbeing.