Sleep quality and cognitive impairments in remitted patients with schizophrenia in Nigeria.

BACKGROUND: Despite the ubiquity of sleep disturbance in schizophrenia, it has generally been overlooked as a potential contributor to cognitive impairments. The main aim of this study was to find out if impaired sleep quality contributes to cognitive impairments in patients with a diagnosis of schizophrenia who are in remission. METHODS: The study was conducted at the University College Hospital, Ibadan and State Hospital, Ibadan, Nigeria. The Pittsburgh Sleep Quality Index (PSQI) and Screen for Cognitive Impairment in Psychiatry (SCIP) were applied in this cross-sectional study, to all consecutive and consenting remitted outpatients with schizophrenia (N=130). Other instruments such as Hamilton Depression Rating Scale (HDRS), the Positive and Negative Syndrome Scale (PANSS), sociodemographic and clinical measures were also applied. RESULTS: There were 130 participants made up of 69 females (53.1%) and 61males(46.9%). The mean age of the participants was 38.5±9.1 years. The prevalence of poor sleep quality in remitted patients with schizophrenia was 56.9%. Sleep quality was significantly negatively correlated with Verbal Learning Test-Immediate (VLT-I) (r(128)=-.18, P=.044) and Verbal Learning Test-Delayed (VLT-D) (r(128)=-.18, P=.037). The variables that independently predicted cognitive functioning were the VLT-I, odds ratio (OR) 0.66; 95% confidence interval ((CI) 0.49-0.88) and education (OR) 0.61;(CI) 0.40- 0.92). CONCLUSION: Poor subjective sleep quality measured by the PSQI is linked to cognitive impairment in remitted patients with schizophrenia. We suggest that sleep quality in remitted patients with a diagnosis of schizophrenia should receive better attention by physicians.

Attitudes towards community based residential care for people living with HIV/AIDS in Nigeria.

Community based care and support are important aspects of HIV/AIDS management in resource-poor African countries in view of increasing incidence of the disease and absence of a cure. A representative community sample (n = 2040) selected using a clustered stratified selection procedure was studied in Ogun, Oyo, and Osun states. A single item question which formed part of a larger survey of the stigma of mental illness was used to elicit information about the opinion of respondents regarding provision of a group home in their neighborhood for the care of persons experiencing a range of medical and social conditions which include HIV/AIDS, mental handicap, previous jail term, physical disability, mental illness, and drug abuse. Of the respondents, 906 (44.4%) were males and 1134(55.65) were females. The mean age was 43.5 (SD 19.72). Over 71% of the respondents disagreed or strongly disagreed with the location of a residential care for persons living with HIV/AIDS (PLWHA) in their neighborhood. This level of rejection was only comparable to that for drug addicts and alcoholics. PLWHA's were more likely to be rejected than ex-convicts for whom about 55% expressed rejection. Decreasing education (X2 = 32.55, p < 0.003) lower income (X2 = 21.25, p < 0.01), urban residence of the respondents (X2 = 15.11, p < 0.05) and female gender (X2 = 9.25, p < 0.05) were associated with a negative attitude to such a residential care for PLWHA. These results suggest a deep-seated prejudice against the provision of a group home for the PLWHA. A community-based enlightenment program anchored on the nature and course of HIV/AIDS should be part of a holistic management approach to the disease.