Prevalence, Factors, and Outcome of Physical Violence against Mental Health Professionals at a Nigerian Psychiatric Hospital.

OBJECTIVES: This cross-sectional study aimed to assess the prevalence, factors, and consequences of physical violence by mentally ill patients against mental health professionals. METHODS: 124 of 145 mental health professionals at a Nigerian neuropsychiatric hospital satisfactorily completed a questionnaire on their experiences with physical assault. RESULTS: 77 (62.1%) staff had been assaulted during their whole career; 38 (30.6%) of them were assaulted in the past 12 months. The most common type of assault was pushing (32.9%). The most common antecedent event to assault was calming an aggressive patient (44.1%). In their whole career, 22.1% of assaulted staff sustained injuries that required medical attention; 42.4% of assaulted staff sometimes or frequently/always experienced posttraumatic stress disorder symptoms. Physical assault in the whole career was associated with older age (p = 0.04), longer years of practice (p = 0.01), and job dissatisfaction (p = 0.05). CONCLUSIONS: Physical violence encountered by mental health professionals at a Nigerian neuropsychiatric hospital is substantial. Policy review of staff safety, training, and support is recommended.

Unmodified electroconvulsive therapy: changes in knowledge and attitudes of Nigerian medical students.

BACKGROUND: The relevance of ECT as a treatment option for some psychiatric disorders continues to generate debate in professional and lay circles. Scientific evidence as to the effectiveness of ECT (with anaesthesia) abounds. In some developing countries, the process of change towards the full implementation and use of modified ECT has been slow. The unmodified format is still used for largely economic reasons despite the ethical concerns it raises. OBJECTIVE: We assessed the effect of an intervention (60 minute lecture on ECT, viewing a live ECT session, following up a patient who had received ECT) during a clinical psychiatry rotation, on medical students' knowledge of and attitude toward unmodified electroconvulsive therapy METHOD: A 14-item self administered questionnaire was administered to 5(th) year medical students at the commencement of their psychiatry rotation, then 4 weeks later to assess knowledge of and attitudes toward unmodified ECT RESULTS: There were significant improvements in knowledge and change in attitude measures to myth about ECT following our intervention. However, viewing live unmodified ECT sessions did not improve the students' acceptability of the procedure. CONCLUSION: Exposure of medical students to ECT and lectures are important in changing negative attitudes during clerkships and should be incorporated in their teaching curriculum. We may infer that future psychiatrists would prefer the modified form of ECT and acceptability would be better with this format.