ABSTRACT
BACKGROUND: There is a high prevalence of psychoactive substance use among patients with mental health disorders. The optimal treatment of patients with mental health disorders requires an awareness of their history pertaining substance use. Several methods are used to assess the use of substance. Each of them embodies its limitations. This study aimed at assessing the diagnostic capability of a self-report psychoactive substance use among patients at the National Psychiatric University Hospital of Cotonou, Benin. METHODS: A cross-sectional survey was conducted from August 1, 2021 to November 24, 2021. A total of 157 consenting patients admitted to psychiatric consultations were successively enrolled in the ongoing study. They were screened for the use of psychoactive substance with Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), followed by urine test using the NarcoCheck® kit for qualitative detection of substances or its metabolites. To assess the diagnostic capability, the participants' self-responses were compared with their urine test results. The sensitivity, specificity, positive and negative predictive values, and kappa coefficient were also calculated. RESULTS: The frequency of lifetime psychoactive substance use according to self-report was 81.5% (95% CI: 0.746-0.873), while over the past three months (recent use) was 52.2% (95% CI: 0.441-0.603) and 58.6% based on the urine test. Alcohol, tobacco and cannabis were the most prevalent psychoactive substance used. The overall concordance between self-reported psychoactive substance use and the urine test (gold standard) was moderate (sensitivity = 66%; kappa = 0.46). Self-report cocaine use compared with urine test showed the highest concordance (sensitivity = 100%; kappa = 79%), followed by tobacco (sensitivity = 58%, kappa = 41%). On an average 70% of urine test results were consistent with self-report (VPP). Participants' were more accurate when they were reporting no psychoactive substance use as suggested by the high negative predictive value (NPV). CONCLUSION: Diagnostic capability of self-reporting of psychoactive substance use among patients admitted to psychiatric consultations was moderate. Therefore self-reporting may not estimate the exact prevalence of psychoactive substance use. Optimal identification of psychoactive substances use in psychiatric patients requires both history and urine testing. The integration of these two approaches is an excellent method to find out the level, frequency and nature of drug used.
Subject(s)
Ethanol , Referral and Consultation , Humans , Benin/epidemiology , Self Report , Cross-Sectional Studies , Africa, WesternABSTRACT
Le corps joue un rôle primordial dans la relation avec l'autre et tient une place importante dans l'écoute chez l'Africain. Ce travail met en exergue l'hyperstimulation qui est faite du corps de l'Africain pendant les différentes étapes de la structuration de la personnalité. A travers la multiplicité de ses expressions, le corps investi va manifester un désir profond d'écoute. Il s'agit d'une écoute qui ne se limite pas à la simple perception sensorielle mais une écoute doublée d'un décodage de ce qui est au-delà du dicible, une écoute des mots mais aussi des maux. Ce type de communication est décrit à travers deux cas cliniques suivis au CNHU-HKM de Cotonou en 2017. Il s'est agi de deux jeunes adolescentes qui ont utilisé leurs corps pour exprimer les maux sur lesquels elles n'arrivaient pas à mettre des mots. Le corps est aussi le lieu de projection de la souffrance et de pratiques thérapeutiques : corps malade, corps soumis à des thérapies traditionnelles, des rites initiatiques. Il est important que le thérapeute sache décrypter les langages la plupart du temps codés du corps, en se référant aux valeurs vitales, esthétiques, et fonctionnelles qui lui sont rattachées pour mieux le soigner.
The body plays an essential role in the relationship with the other and holds an important place in the African's listening. This work highlights the hyperstimulation of the African's body during the different stages of personality structuring. Through the multiplicity of its expressions, the invested body will manifest a deep desire to listen. It is a listening that is not limited to a simple sensory perception but a listening coupled with a decoding of what is beyond the dicible, a listening of words but also of evils. This type of communication is described through two clinical cases monitored at CNHU-HKM Cotonou in 2017. These were two young teenage girls who used their bodies to express the ailments on which they could not put words. The body is also the place where suffering and therapeutic practices are projected: the sick body, the body subjected to traditional therapies, initiation rites. It is important that the therapist knows how to decipher the most commonly coded languages of the body by referring to the vital, aesthetic and functional values associated with it in order to better care for it.
Subject(s)
Humans , Male , Female , Kinesics , Personality Development , Psychopathology , Disease , CultureABSTRACT
La prise en charge des malades mentaux nécessite d'intégrer leur famille dans l'équipe soignante. Ce travail montre l'intérêt de la psychoéducation dans la prise en charge des patients souffrant de schizophrénie. 40 parents de patients souffrant de schizophrénie ont bénéficié par groupes fermés de 10 du programme Profamille dans le but d'accroitre l'efficacité de la prise en charge. Des modules psychoéducatifs leur ont été proposés. 72,5% des participants étaient de sexe féminin. Pour tous les groupes réunis 45% ont débuté et terminé les séances. Pour 49,12% des participants les causes de la schizophrénie sont d'ordre culturel. Leurs premières réactions face à la maladie sont tardives et les troubles anxiodépressifs représentent les principales répercussions de la maladie. L'application de ce programme a permis de discuter des croyances sur la maladie, d'accroitre le niveau de connaissance des parents sur la schizophrénie, de leur faire acquérir des compétences pour y faire face. Le programme profamille permet d'accroitre l'efficacité thérapeutique.
The care of the mental sick requires to integrate their family into the medical team. This work shows the interest of psychoeducation in the management of schizophrenics. 40 parents of schizophrenics benefited by groups closed by 10 of the program profamille in order to increase the efficiency of care. The various psychoeducatif modules have been proposed to them. 72.5% of the participants were female. For all the gathered groups, 45% began and ended the sessions. For 49.12% of the participants the causes of schizophrenia are of cultural order. Their first reactions in front of the disease are late and the anxiodepressifs disorders represent the main repercussions of the disease. The application of this program allowed to discuss beliefs about the disease, to increase parents' knowledge of the schizophrenia, and to make them acquire skills to face it. The profamily program allows to increase the therapeutic efficiency.
