Antipsychotics-related hyperprolactinaemia among patients with schizophrenia in Maiduguri.

Background: Hyperprolactinaemia among patients on antipsychotic medications is generally overlooked due to lack of outwardly visible symptoms, patient resistance to reporting because the symptoms are perceived as shameful, or to clinician's insufficient knowledge. Aim: The study aimed to evaluate the patterns and correlates of hyperprolactinemia among patients with schizophrenia on antipsychotic medications. Setting: The study was conducted in a psychiatric facility in Maiduguri, Northeastern Nigeria. Methods: A total of 209 patients with schizophrenia were evaluated through a cross-sectional design and assayed for serum prolactin with ELISA Kits. Frequencies and percentages were tabulated for categorical variables. Variables with significant associations with hyperprolactinaemia on chi-square (p < 0.05) were subjected to logistic regression analysis. Results: The prevalence of hyperprolactinaemia was 45.9% in all patients on antipsychotic medication. The prevalence because of the use of typical and atypical antipsychotics was 51.5% and 25.0%, respectively. Hyperprolactinaemia was significantly associated with typical antipsychotics (ß = 0314, p = 0.002), high overall drug dosage (ß = 2.340, p = 0.003), high-dose typical antipsychotics (ß = 3.228, p = 0.000), twice daily dosing frequency (ß = 2.751, p = 0.001) and polypharmacy (ß = 1.828, p = 0.0024). Conclusion: The findings support that patients on typical, high-dose antipsychotic medications and polypharmacy have a high prevalence of hyperprolactinaemia. As hyperprolactinaemia is often undetectable, screening and patient psycho-education on the significance of the signs and symptoms of hyperprolactinaemia is required for necessary clinical intervention. Contribution: The study provides evidence for the rational use of antipsychotic medications in sub-Saharan Africa.

The epidemiology of psychiatric disorders in Africa: a scoping review.

This scoping review of population-based epidemiological studies was done to provide background information on the prevalences and distribution of psychiatric disorders in Africa for calls to broaden diversity in psychiatric genetic studies. We searched PubMed, EMBASE, and Web of Science to retrieve relevant literature in English, French, and Portuguese from Jan 1, 1984, to Aug 18, 2020. In 36 studies from 12 African countries, the lifetime prevalence ranged from 3·3% to 9·8% for mood disorders, from 5·7% to 15·8% for anxiety disorders, from 3·7% to 13·3% for substance use disorders, and from 1·0% to 4·4% for psychotic disorders. Although the prevalence of mood and anxiety disorders appears to be lower than that observed in research outside the continent, we identified similar distributions by gender, although not by age or urbanicity. This review reveals gaps in epidemiological research on psychiatric disorders and opportunities to leverage existing epidemiological and genetic research within Africa to advance our understanding of psychiatric disorders. Studies that are methodologically comparable but diverse in geographical context are needed to advance psychiatric epidemiology and provide a foundation for understanding environmental risk in genetic studies of diverse populations globally.

Assessing Change Readiness and Treatment Eagerness among Psychoactive Substance Users in Northern Nigeria.

Studies on psychoactive substance use in Nigeria had focused on prevalence and rarely on treatment implication(s) of large rates reported. Further challenge was to find suitable instruments to monitor change readiness as well as predict treatment outcomes along motivation continuum and according to resilience characteristics. Such ability will not only help to match treatment strategy with stage of change but also come with a more satisfactory outcome. This study therefore provided psychometric properties of one of such measuring scales: Stage of Change Readiness and Treatment Eagerness Scale version 8 (SOCRATES-8) and the accompanying change in resilience among Nigerians using psychoactive substances. Participants were 111 psychoactive substance dependent users in three treatment centers in Northern Nigeria. All respondents filled sociodemographic questionnaire, SOCRATES-8 and 14-item Resilience Scale. The study found overall motivation for change among participants to be medium on the three subscales of SOCRATES-8: ambivalence (median=14.00; range=7-20); recognition (median=31.00; range=7-35); and taking steps (median=35.00; range=12-40). More than half (61.3%) scored moderately on resilience. The Internal reliability of SOCRATES-8's subscales fell into acceptable range (ambivalence=0.54; recognition=0.87; taking steps=0.84). Pearson correlation coefficients of subscales with resilience are positive and in moderate range except for ambivalence with very low coefficient. Hierarchical cluster analysis based on participants' resilience characteristics yields five distinct profiles corresponding to five stages of motivational change. ANOVA of these five profiles based on SOCRATES' 3 subscales was significant. The study demonstrates utility of SOCRATES-8 to assess change readiness and treatment eagerness of psychoactive substance abusers according to stages of change and their resilience characteristics. This will aid treatment planning and can also measure treatment outcome.

Stigmatisation of mental illness among employees of a Northern Nigerian University.

BACKGROUND: Prejudices against people with mental illness are widespread in many societies leading to a number of detrimental consequences. In order to adequately develop programmes and services that will help protect the rights and privileges of people with mental illness, it is imperative to study the nature of stigma and factors associated with it. Our objective in this study was to observe the level of stigmatisation of the mentally ill among employees of a Nigerian University and the factors associated with it. MATERIALS AND METHODS: The study was carried out at the Ahmadu Bello University Teaching Hospital and the Ahmadu Bello University main campus. Employing a two-staged random sampling technique, 15 departments were chosen from both institutions, after which 10 participants were further sampled from each department to obtain a total of 150 participants. All the participants were administered the socio-demographic questionnaire and Mental Illness Clinicians' Attitude 4(th) version (MICA 4). RESULTS: The findings indicate that 53.4% of respondents' classified as high stigmatisation while 46.6% was classified as low stigmatisation. Low scores on stigmatisation were observed among departments of psychiatry, nursing and ophthalmology, while high scores were observed among respondents from administration and engineering. Relationship between variables and predictors of stigmatisation were also established. CONCLUSION: There is a high tendency to stigmatise persons with mental illness except where there has been some contact with mental health practice or among the clinical departments in the hospital. We recommend community psychiatry care for the mentally ill and psycho-education for staff periodically to reduce this level of stigmatisation.

The perception of family function by adolescents with epilepsy in a rural nigerian community.

The family plays a significant role in epilepsy management in sub-Saharan Africa and how this role is perceived by persons with epilepsy could influence epilepsy outcomes. The objective of the study was to assess perception of family function by adolescents with epilepsy (AWE). The sociodemographic and epilepsy characteristics of AWE in a rural Nigerian community were assessed and the Family APGAR tool was used in assessing their perception of satisfaction with family functioning. Adolescents (n = 1708) constituted 26% of the community's population and 18 (10.5/1000) had epilepsy. The AWE age range was 11-19 years (mean 16.7 ± 2.6 years) with a male preponderance (15, 83.3%). The family was the only source of care. Family dysfunction (Family APGAR Score <7) was indicated by 15 (83.3%) of the AWE. The strongest perception of family function was in adaptability while the weakest was with growth. The indication of family dysfunction was significant (P<0.05) in the older (age 14-19 years) AWE when compared with the younger AWE (11-13 years) in the study. Most of the AWE indicated living in a dysfunctional family setting. The study highlights the need to address the role of the family in the provision of comprehensive epilepsy care.

Stigmatization of people with mental illness among inhabitants of a rural community in northern Nigeria.

BACKGROUND: Despite the fact that mental illness is a common problem in society, people's perception of the mentally ill and community attitude towards them is still rather poor, making their rehabilitation and reintegration into society an uphill task. AIMS: To examine the stigmatization of people with mental illness within a rural community and identify the socio-demographic variables involved. METHOD: A cross-sectional descriptive study using a multi-stage random sampling technique to obtain data through an interviewer-administered questionnaire to 325 adult inhabitants of a rural community in Nigeria. RESULTS: The results showed widespread ignorance about causation, mode of transmission and remedies available for mental illness, with only 0.9% of respondents attributing mental illness to brain disease. The others attributed it to spiritual attack, punishment for evil doing and illicit psychoactive substance use, among other things. Negative views about the mentally ill were also widely expressed resulting in discriminatory practices. CONCLUSION: Stigmatization of people with mental illness is still rampant in our community. There is a need for adequate public education about the causes and mode of transmission of mental illness and the treatment options available in the community.

Prevalence of dementia and dementia subtypes among community-dwelling elderly people in northern Nigeria.

BACKGROUND: Dementia has important public health implications. The magnitude of the problem remains largely unknown in the developing countries. METHODS: Three hundred and twenty-two community dwelling elderly persons and their caregivers in Zaria, Northern-Nigeria were enrolled in this study. They were interviewed using Community Screening Interview for Dementia (CSI-D), Consortium to Establish Registry for Alzheimer's disease (CERAD), Stick Design Test (SDT), Blessed Dementia Scale and a sociodemographic questionnaire. The data obtained were analyzed using the Statistical Package for Social Sciences version 15 for Windows. Diagnosis was based on fulfilling criteria for dementia in both the International Classification of Disease, 10th edition and the Diagnostic and Statistical Manual, 4th edition. RESULTS: The mean age of the subjects was 75.5 ± 9.4 years. The prevalence of dementia was 2.79% (CI 1-4.58%). Alzheimer's disease constituted 66.67% of all the cases of dementia in this community. Age was the only demographic factor associated with dementia. CONCLUSION: The prevalence rates of dementia and dementia subtypes in the developing countries are similar using standard diagnostic criteria and methods.