Sleep Hygiene Index: Psychometric Characteristics and Usefulness as a Screening Tool in a Sample of Nigerian Undergraduate Students.

STUDY OBJECTIVES: The objectives of this study were to investigate the psychometric properties of the Sleep Hygiene Index (SHI) and determine its capacity to screen for poor sleep quality in a nonclinical sample of Nigerian university students. METHODS: A total of 348 students appropriately completed the SHI, the Morningness-Eveningness Questionnaire (MEQ), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). RESULTS: The internal consistency (Cronbach alpha) of the SHI was .64 and its construct validity was modestly satisfactory. It had a significant negative correlation with the MEQ (r = -.170, P < .001) and positive correlations with global PSQI (r = .289, P < .001) and ESS (r = .219, P < .001) scores. Prior to the factor analysis, our sample was randomly divided into two. In one half of the sample (sample 1), exploratory factor analysis of the SHI items yielded a three-factor model. Confirmatory factor analysis on the other half (sample 2) corroborated this model with satisfactory indices of fitness (c2 = 67.805; df = 55; c2/df = 1.233; P = .115; goodness of fit index = .943; Tucker-Lewis index = .958; incremental fit index = .972; comparative fit index = .970; root mean square error of approximation = .037). A cutoff total score of 16 on the SHI had the best sensitivity (77.0%) and specificity (47.5%) to identify students who were categorized as experiencing poor sleep quality, according to the PSQI (area under the curve = 0.65, 95% confidence interval = 0.59-0.71). CONCLUSIONS: The SHI exhibited satisfactory psychometric properties as a self-rated assessment instrument in the evaluation of sleep hygiene and as a screening instrument for poor sleep quality among Nigerian undergraduate students.

Public Awareness and Attitude Towards Depression: A Community Based Study Among an Adult Population in Ile-Ife South-Western Nigeria.

Depression has become a global health priority due to its associated burden. However, there is dearth of information regarding the public awareness and attitude towards depression in Nigeria. This study aimed to assess the level of public awareness and attitude towards depression in a semi-urban Nigerian community. A cross-sectional study conducted among 240 respondents with mean age of 34.7 years (± 1.2 years). A questionnaire assessed socio-demographic characteristics, level of awareness and attitude of people towards depression. While most respondents (72.5%) had heard about depression, it was less recognized as a major mental health problem. Also, most respondents (58.6%) had negative attitudes toward depression. There is low level of awareness of depression as a major health problem among community dwellers in South-western Nigeria and negative attitudes towards the illness also appear prevalent. Therefore, awareness should be improved through public health enlightenment programmes.

Obsessive-compulsive symptoms in schizophrenia: prevalence and associated factors in a Nigerian population.

OBJECTIVES: The objectives of this study were to determine the prevalence of obsessive-compulsive symptoms (OCS) among subjects with schizophrenia and also to determine their associated factors. METHODS: A cross-sectional study involving 232 patients with schizophrenia were recruited from a teaching hospital in Nigeria. Socio-demographic questionnaire, Obsessive-Compulsive Inventory, Positive and Negative Syndrome Scale and Suicidality module of the MINI International Neuropsychiatric Inventory were administered. RESULTS: The prevalence of OCS was 54.3% among patients with schizophrenia, and washing symptom was the most common (51.7%). Patients with schizophrenia that had OCS had more severe psychopathologies and higher levels of suicidality. OCS among patients with schizophrenia were also associated with the use of second-generation antipsychotic medications. CONCLUSIONS: OCS are common in schizophrenia. Hence, there is a need for routine screening of patients with schizophrenia for OCS and then, manage them appropriately.

Disability assessment as an outcome measure: a comparative study of Nigerian outpatients with schizophrenia and healthy control.

BACKGROUND AND OBJECTIVE: Schizophrenia is a chronic mental disorder that leads to disability in several aspects of the individual's personal, social, and occupational functioning. This study assesses and compares the level of disability among Nigerian outpatients with schizophrenia and healthy controls (HC). METHODS: A comparative cross-sectional study among 100 schizophrenia outpatients with an ICD-10 diagnosis and 100 HC was conducted over a 4-month period. They completed a questionnaire containing the Zung's Self-Rating Depression Scale (SDS), the World Health Organization Disability Assessment Schedule-Second Version (WHODAS-II). Symptoms of schizophrenia were assessed with the Positive and Negative Syndrome Scale (PANSS). Student's t tests and Chi-square were used to compare patient with schizophrenia and healthy control. Pearson correlation and multiple linear regression analyses were used to assess the relationships of socio-demographic and clinical variable with disability. RESULTS: The patients with schizophrenia reported greater disability than the HC on most of the disability domains of WHODAS-II. They also reported significantly higher mean Zung's SDS scores than the HC. Depressive symptoms, negative symptoms, and PANSS total were significantly related to all the WHODAS-II domains. The disability summary score was significantly predicted by depressive symptoms, negative and positive symptoms of schizophrenia, number of active symptoms (relapse) of schizophrenia, and marital status [F (5, 94) = 23.90, p < 0.001]. CONCLUSION: Schizophrenia is a disabling disorder that affects different aspects of a patient's life. Treatment strategies that target these different aspects may help in reducing disability.

Relationship between depressive symptoms and quality of life in Nigerian patients with schizophrenia.

PURPOSE: Quality of life (QOL) in patients with schizophrenia is influenced by various factors such as depressive symptoms. This study assessed the relationship between depressive symptoms and QOL in outpatients with schizophrenia in Nigeria and evaluated the associated socio-demographic and clinical factors. METHODS: One hundred patients with 10th edition of the International Classification of Diseases diagnosis of schizophrenia participated in this study. Socio-demographic and clinical factors such as depression were assessed with Zung Self-rating Depression Scale and symptoms of schizophrenia with the Positive and Negative Syndrome Scale of schizophrenia (PANSS). The level of functioning was assessed with the Global Assessment of Functioning Scale. QOL was assessed using the brief version of the World Health Organisation Quality of Life Scale. RESULTS: There were 27 (27.0 %) patients with depression. The depressed patients reported significant lower scores in all QOL domains when compared with the non-depressed group. All QOL domains were significantly negatively correlated with the total PANSS and all its subscales (except for psychological domain with total PANSS and social relationship and environmental domains with PANSS positive). Severity of depressive symptoms was significantly negatively correlated with all QOL domains. Functioning was significantly positively correlated with all QOL domains except in the environmental domain. Multiple regression analysis showed that depressive symptoms predicted all QOL domains except the social relationship domain while negative symptoms predicted social relationship and environmental domains. CONCLUSION: Depression is a common occurrence during the course of schizophrenia. Depressive and negative symptoms have a significant impact on the QOL of patients with schizophrenia.

Reproductive mental health risk in Nigeria: myths, facts and challenges.

It is widely known that Africans and especially Nigerians place much emphasis on childbearing. It has been said that the effect of childbirth relates to the society and culture's response to parenthood and the existing family structure. Many rituals exist in African societies to signify the changes in women's identity, roles and status during pregnancy and following childbirth. Earlier studies have suggested that perinatal emotional distress is rare among women in sub-Saharan Africa, with the supposed intact family structure in the region acting as a protective factor.

Impact of postnatal depression on infants' growth in Nigeria.

BACKGROUND: The contribution of maternal postnatal depression to infant growth and under-nutrition in Africa has not been well studied. This study aims to examine the impact of postnatal depression (PND) on infants' physical growth in the first 9 months of life in Nigeria. METHODS: A longitudinal case controlled study in which 242 women (consisting of 120 depressed and 122 matched non-depressed postpartum women) had their infants' weight and length measured at the 6th week, 3rd month, 6th month and 9th month after delivery. Discontinuation with breastfeeding and illnesses like diarrhoea, persistent vomiting, fever and cough were also recorded at these periods. RESULTS: Infants of depressed mothers had statistically significant poorer growth than infants of non-depressed mothers at the 3rd month (weight OR 3.41, 95% CI 1.30-8.52; length OR 3.28, 95% CI 1.03-10.47) and the 6th month postpartum (weight OR 4.21, 95% CI 1.36-13.20; length OR 3.34, 95% CI 1.18-9.52). Depressed mothers were more likely to stop breastfeeding earlier and their infants more likely to have episodes of diarrhoea and other infectious illnesses. LIMITATIONS: Psychiatric interview was conducted only once (at 6 weeks postpartum), our sample size was moderate and we did not account for mothers who had been depressed in pregnancy. CONCLUSION: Prevention of postnatal depression and close monitoring of the growth of infants of depressed mothers should be integrated into maternal and child health policies in this region.

Prevalence of major depressive disorders and a validation of the Beck Depression Inventory among Nigerian adolescents.

AIM: The aims of this study are to estimate the prevalence of major depressive disorder (MDD) in a representative sample of Nigerian adolescents, and to assess the validity of Beck Depression Inventory (BDI) in screening for depressive symptoms among adolescent population in Nigeria. METHOD: A total of 1095 adolescents aged 13-18 years attending senior secondary schools completed the BDI. The presence of MDD in the adolescents was assessed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Epidemiological Version 5 (K-SADS-E). RESULT: The prevalence of MDD was 6.9%. (male = 5.5%, female = 8.9%). The difference between the rates for MDD in males and females was statistically significant (P = 0.028), but no age or age-gender-interaction difference was found. The BDI has good psychometric properties in screening for depression in adolescents. At a cut off score of 18 and above, the BID has a sensitivity of 0.91, specificity of 0.97, positive predictive value (PPV) of 0.88 and negative predictive value (NPV) of 0.98. CONCLUSION: The prevalence of MDD in Nigerian adolescents is comparable to those found in western culture and the BDI is a valid instrument for screening for MDD among Nigerian adolescents. Health policies in developing countries must integrate adolescents' depression as a disorder of public health significance.

Validity of the Pittsburgh Sleep Quality Index (PSQI) among Nigerian university students.

OBJECTIVES: Sleep-related problems and detection of them remain largely an unidentified public health issue, especially among university students. This study aims to assess the validity of the Pittsburgh Sleep Quality Index (PSQI) among Nigerian university students. METHODS: Five hundred and twenty students completed the PSQI, the 12-item General Health Questionnaire (GHQ-12) and questionnaires pertaining to socio-demographic details. The students were then interviewed for the diagnosis of insomnia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV) and the International Classification of Sleep Disorders, revised criteria (ICSD-R). RESULTS: The PSQI was of moderate value in screening for insomnia, with the best cut-off score at 5 (sensitivity 0.720, specificity 0.545, overall correct classification rate 0.554). The correlation between the PSQI and the GHQ-12 was 0.252 (p<0.001). A 3-factor model was generated by principal component analysis. CONCLUSION: The psychometric value of PSQI in screening for insomnia among Nigerian students was moderate compared to what has been obtained in Western cultures. Nonetheless, it is still a useful instrument in the detection of sleep problems in this population.

Prevalence and correlates of depression in late pregnancy among Nigerian women.

The objectives of this study were to estimate the prevalence of depressive disorder in late pregnancy in a group of Nigerian women and to examine the associated factors. One hundred and eighty women in late pregnancy completed a questionnaire on sociodemographic and obstetrical details. They also completed the Edinburgh Postnatal Depression Scale (EPDS). A proportion of them were then assessed for the DSM-IV diagnosis of depressive disorder. Fifteen (8.3%) women met the current (2 weeks) DSM-IV diagnosis of depressive disorder. The factors independently associated with depression included being single [odds ratio (OR)=16.67, 95% confidence interval (CI)=3.17-87.76], divorced/separated (OR=11.11, 95% CI=1.55-19.65), polygamous (OR=3.92, 95% CI=0.94-16.33), and having a previous history of stillbirth (OR=8.00, 95% CI=1.70-37.57) and perceived lack of social support (OR=6.08, 95% CI=1.42-26.04). Depression is common in late pregnancy among Nigerian women, with the significant correlates including mainly social and family factors. Such factors should be considered when planning health care services or formulating a predictive model. Interventions aimed at reducing the occurrence of antenatal depression need further research.

Gender differences in the relationship between alcohol use and anxiety symptoms among Nigerian college students.

Few studies have addressed the effect of gender on the relationship between alcohol and anxiety. Students in a Nigerian university, grouped into five separate categories of alcohol use completed the Zung's Self Rating Anxiety Scale. Although a non-linear "J shaped" relationship was found between alcohol use and anxiety symptoms among males, a linear relationship was found among females. Women tend not to share the positive effect moderate alcohol use confers on anxiety status. This gender difference may be an important consideration when planning preventive strategies for alcohol related problems in Nigerian youths.

Depression amongst Nigerian university students. Prevalence and sociodemographic correlates.

BACKGROUND: This study aimed to estimate the prevalence and examine the socio-demographic correlates of depressive disorder among university students in Western Nigeria. METHODS: A representative sample of students living in the halls of residence of a federal university (n = 1,206) completed sets of questionnaires on socio-demographic details, problems encountered in the university, alcohol use and smoking. Depressive disorder was assessed using the Mini International Neuropsychiatric Interview (MINI). RESULTS: A total of 101 (8.3%) students met the criteria for depressive disorder with 68 (5.6%) having minor depressive disorder and 33 (2.7%) having major depressive disorder. The factors that were significantly associated with depressive disorders in the students include problems with accommodation (OR 2.72, 95% CI 1.79-4.16), very large family size (OR 2.8, 95% CI 1.42-5.73), female gender (OR 2.21, 95% CI 1.46-3.35), heavy cigarette smoking (OR 3.67, 95% CI 2.23-6.05) and high level of alcohol consumption (OR 9.44, 95% CI 3.32-26.89). CONCLUSIONS: Depression is common among Nigerian university students and significantly associated with sociodemographic factors. An effective model for the prediction of the development of depression in university students need to be developed and evaluated and interventions aimed at reducing the incidence of depression among this population need further research.