Determinants of quality of life in adults living with epilepsy.

Background: Quality of life (QOL) is a vital outcome measure in people living with epilepsy. The aim of this study is to determine the sociodemographic and clinical factors that predict poor QOL in patients with epilepsy. Materials and Methods: This is a descriptive cross-sectional study that was carried out at the outpatient psychiatric clinic of Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria, for 6 months. Seventy-four patients with epilepsy who met the inclusion criteria were recruited to participate in the study. The mental health of these patients and their QOL were assessed using the Mini-International Neuropsychiatric Interview and the short form of the World Health Organization QOL instrument, respectively. Data were analyzed using epi-info version 6.04d, and logistic regression analysis was performed to determine factors that predict poor QOL. Results: Psychiatric disorder was found in 33 (44.6%) of the respondents. The presence of these psychiatric disorders was predictive of poor score on the overall QOL (odds ratio [OR] = 0.382; 95% confidence interval [CI] = 0.145-0.983; P = 0.0046), physical (OR = 0.269; 95% CI = 0.100-1.722; P = 0.009), and psychological health domain (OR = 0.269; 95% CI = 0.102-0.709; P = 0.008). Longer duration of epilepsy was predictive of a poor score on the health satisfaction item (OR = 0.202; 95% CI = 0.06-0.679; P = 0.010) while being single was predictive of poor score on the social relationship domain (OR = 0.177; 95% CI = 0.065-0.482; P = 0.001). Conclusion: The presence of psychiatric disorder, long duration of epilepsy, and being single were predictive of poor QOL. The importance of social relation, prompt seizure control, and efficient collaboration between psychiatrist and other medical professionals in the care of patients with epilepsy cannot be overemphasized.

RésuméContexte: La qualité de vie (QV) est une mesure de résultat vitale chez les personnes vivant avec l'épilepsie. Le but de cette étude est de déterminer la facteurs sociodémographiques et cliniques qui prédisent une mauvaise qualité de vie chez les patients épileptiques. Matériel et Méthodes: Ceci est une description étude transversale réalisée à la clinique psychiatrique ambulatoire de l'hôpital universitaire Abubakar Tafawa Balewa, Bauchi, Nigeria, pendant 6 mois. Soixante-quatorze patients épileptiques répondant aux critères d'inclusion ont été recrutés pour participer à l'étude. Le mental la santé de ces patients et leur qualité de vie ont été évaluées à l'aide de l'interview neuropsychiatrique Mini International et de la forme abrégée de World Instrument de qualité de vie de l'Organisation de la santé, respectivement. Les données ont été analysées en utilisant epi-info version 6.04d, et une analyse de régression logistique a été réalisée pour déterminer les facteurs qui prédisent une mauvaise qualité de vie. Résultats: Un trouble psychiatrique a été trouvé dans 33 (44,6%) des répondants. La présence de ces troubles psychiatriques étaient prédictifs d'un mauvais score sur la QV globale (odds ratio [OR] = 0,382; intervalle de confiance à 95% [IC] = 0,145-0,983; P = 0,0046), physique (OR = 0,269; IC à 95% = 0,100-1,722; P = 0,009) et domaine de la santé psychologique (OR = 0,269; IC à 95% = 0,102-0,709; P = 0,008). Une plus longue durée d'épilepsie était prédictive d'un mauvais score sur l'item de satisfaction pour la santé (OR = 0,202; IC à 95% = 0,06-0,679; P = 0,010) tout en étant célibataire était prédictif d'un mauvais score sur le domaine des relations sociales (OR = 0,177; IC à 95% = 0,065-0,482; P = 0,001). Conclusion: La présence de troubles psychiatriques, la longue durée de l'épilepsie et le fait d'être célibataire étaient prédictifs d'une mauvaise qualité de vie. L'importance de relation sociale, contrôle rapide des crises et collaboration efficace entre le psychiatre et d'autres professionnels de la santé dans la prise en charge des patients avec l'épilepsie ne peut pas être surestimée.

The predictors of psychiatric disorders among people living with epilepsy as seen in a Nigerian Tertiary Health Institution.

BACKGROUND: Mental disorders may complicate epilepsy which can further impair the quality of life of people living with this chronic neurological condition. The aim of this study was to determine the types of psychiatric disorders in patients with epilepsy and to determine the sociodemographic and clinical factors that may predict these psychiatric illnesses. MATERIALS AND METHODS: This is a descriptive cross-sectional study carried out over a period of 6 months at Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria. The Mini International Neuropsychiatric Interview was used to determine the psychological health of 74 consecutively recruited adult patients with epilepsy attending the psychiatric outpatients' clinic of the hospital. Psychiatric diagnoses were based on Diagnostic and Statistical Manual for Mental Disorders, 4(th) Edition criteria, and logistic regression analysis was done to determine variables that predict psychiatric disorder. RESULTS: Majority of the participants were male (67.6%) with their age ranging from 18 to 68 years and the mean age of 30.55 ± 10.91 years. Thirty-three (44.6%) of our study respondents had psychiatric diagnoses that included major depressive disorder (21.6%), schizophrenia (17.6%), generalized anxiety disorder (4.1%), and hypomania (1.4%). Being unemployed (odds ratio [OR] = 3.24. 95% confidence interval [CI] = 1.15-9.10, P = 0.026) and short-term seizure free period (OR = 0.19, 95% CI = 0.04-0.78, P = 0.022) were the variables found to be predictive of psychiatric diagnoses. CONCLUSIONS: The study revealed that a large percentage of people living with epilepsy develop mental disorders which can further increase the burden and worsen the quality of life of patients with this chronic debilitating condition.

Psychiatric morbidity in mothers of children attending primary care facility in Ilorin, Nigeria: drawing attention to those affected concurrently with their children.

OBJECTIVE: To determine the prevalence of psychiatric morbidity among mothers of children attending a primary care clinic in University of Ilorin Teaching Hospital as precursor to developing an intervention programme. METHOD: WThree hundred fifty mothers of children aged 7-14 years were screened with the 12-item General Health Questionnaire for psychiatric morbidity. As part of the larger study, their children were screened for psychiatric disorders with the parents' version of the Child Behaviour Questionnaire, and a subsample of 157 mother/child dyad had second-stage interview with the children's version of the Schedule for Affective Disorders and Schizophrenia to determine psychiatric morbidity in these children. RESULTS: Twenty-eight out of 350 mothers (8%) had probable psychiatric morbidity. Mothers with psychiatric morbidity were significantly more likely to have children with Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition psychiatric diagnosis (8 of 28, P=0.011), experience parenting difficulties with some of their children (13 of 28, P=0.000) and have poor husband support for the care of their children. CONCLUSION: The presence of psychiatric morbidity in mothers may require that other members of the family especially the children be screened for psychiatric disorders particularly when there are parenting difficulties and poor spousal support; in this way primary prevention or control can effectively be carried out.

Psychiatric morbidity in paediatric primary care clinic in Ilorin, Nigeria.

BACKGROUND: We observed poor attendance at the recently established child and adolescent psychiatric clinic in our hospital, despite our sensitization efforts prior and after the establishment of the unit. The study was conducted at the paediatric clinics of the Family medicine/General out-patient department (GOPD) of university of Ilorin teaching hospital (UITH), Ilorin. OBJECTIVE: The study was aimed at finding out the prevalence, types and associated factors of psychiatric disorders among children attending the primary care unit of University of Ilorin Teaching Hospital (UITH). METHOD: A cross-sectional two stage study in which 350 children aged 7-14 years were screened with the parents' version of Child Behaviour Questionnaire or Rutter Scale A2. Of these, a stratified sub-sample of 157 (consisting of all high scorers and ~30% of low scorers, randomly selected) were interviewed jointly with their mothers using the children's version of the schedule for affective disorders and schizophrenia (Kiddie-SADS-PL or K-SADS-PL). RESULTS: An overall prevalence of 11.4% (40 of 350) for the presence of one or more DSM IV disorders was obtained. Enuresis with significant distress was present in 6.0%, behavioural disorders of Conduct and ADHD in 3.1%, emotional disorders of depression and anxiety in 1.7% and mental retardation in 0.6%. The presence of chronic medical illness and frequent hospital visits were factors associated with risk of having psychiatric disorders. CONCLUSION: The study supports earlier ones in Nigeria that child psychiatric disorders are common in hospital patients, although differences may exist in pattern and types. It emphasizes the need to screen hospital patients for morbidity to ensure early detection and treatment of psychiatric disorders in childhood. This is to limit the period of illness and avoid its adverse effects on growth and development of the children and to reduce the risk of carrying over remediable problems in childhood into adulthood.