Psychological profile of spouses of women with infertility in Nigeria.

Ninety five men who accompanied their wives to the fertility clinic of a Nigerian teaching hospital (index group) were compared with 95 matched controls using the Hospital Anxiety and Depression Scale (HADS). Their rates of significant anxiety symptoms (24.2%) and depressive symptoms (20.0%) were higher than the corresponding rates of 13.7% and 9.5% for the controls. The higher rate of significant depressive symptoms in the infertility group was significant (p < 0.05). Their mean scores on the two subscales of HADS (anxiety and depressive subscales) were also significantly higher (p < 0.001). Results of multiple regression analysis indicated that lower anxiety symptoms were predicted by age group among subjects in the index group, indicating that belonging to higher age groups was associated with lower anxiety symptoms. In addition, lower anxiety symptoms were predicted by 'being very religious'. However, higher anxiety symptoms were predicted by previous exposure to couple counselling. On the predictors of depressive symptoms, lower symptoms were predicted by age group and religiosity while higher symptoms were predicted by respondents' previous exposure to couple counselling and higher number of wives. Other factors investigated such as level of education, duration of infertility, attitude towards child adoption, pressure from extended family members on account of infertility, expectation of the respondents on the possible outcome of treatment and the result of semen analysis were not observed as predictors of anxiety and/or depressive symptoms. The observations on emotional distress among these men, together with previous observations that counselling/support received from gynecological consultations is usually inadequate indicates that the quality of psychological support that is available to them needs to be improved and modified. Involvement of mental health professionals (psychiatrists and clinical psychologists) in the provision of psychological couple counselling for infertility-related emotional distress could improve the quality of support provided. The establishment of special counselling units in hospitals providing treatment for infertility is advocated.

Factors associated with psychoactive substance use among a sample of prison inmates in Ilesa, Nigeria.

OBJECTIVES: To determine the rates of psychoactive substance use before and during imprisonment among a sample of prisoners and the factors that are associated with current drug use among them. METHODS: All the inmates of Ilesa medium security prison, who gave informed consent to participate, were interviewed with a questionnaire detailing socio-demographic, drug-use and imprisonment-related information. RESULTS: Majority of the prisoners were young adults. The current (one month) use rates of the substances were: tobacco, 13.7%; hypnosedatives, 11.4%; alcohol, 10.7%; stimulants, 9.6%; cannabis, 7.0%; pethidine/morphine, 2.3%; inhalants, 2.3%; cocaine, 2.3%; heroin, 1.3% and LSD, 0.0%. These rates were just slightly lower than rates of use before imprisonment for hypnosedatives, stimulants, cannabis, pethidine/ morphine and inhalants. Majority of current users of cannabis (71.4%) and tobacco (68.3%) were engaged in 'heavy use' of these substances. Analyses of factors that were significantly associated with the five commonly used substances (tobacco, hypnosedatives, alcohol, stimulants and cannabis) indicated that current tobacco use was associated with unemployment before imprisonment, being a sentenced prisoner, previous mental disorder and previous arrest(s) for drug offense. Current hypnosedatives use was associated with being a sentenced prisoner, previous arrest(s) for drug offense and being held for a major offense. Current stimulants use was associated with unemployment, previous arrest(s) for drug offense, previous imprisonment and longer duration of imprisonment. Current cannabis use was associated with higher age groups and being a sentenced prisoner. Cannabis use was also associated with previous arrest(s) for drug offense, previous imprisonment and being held for a major offense, a pattern which suggests that cannabis use may be associated with criminality than the other substances. The observation on pethidire/morphine does not conform to previous observation of non-use by prisoners in Nigeria. CONCLUSION: The rates of drug use are lower than figures reported from samples in western countries but similar to previous reports from Nigeria. The present observation on pethidine suggests that injecting drugs may be an emerging behaviour among prisoners in Nigeria. The prevalence rates of the substances and the similarity in the prisoners' access to drug before and during imprisonment call for drug prevention and treatment programmes within the criminal justice system in Nigeria.

Unfulfilled desire for pregnancy: gender and family differences in emotional burden among a Nigerian sample.

The aims of this study were to compare anxiety and depressive symptoms between a sample of Nigerian women and their husbands on treatment for infertility, and to identify factors, which are associated with emotional burden in their families. In total, 82 women and their spouses completed the two subscales of the Hospital Anxiety and Depression Scale (HADS) at the gynaecology clinics of a Nigerian teaching hospital. The women had a significantly higher mean anxiety score (p<0.001) and higher mean depression score (p <0,001) than their husbands. On both anxiety and depression subscales of the HADS, the scores of the women were positively correlated with their husbands' scores (p<00.1). Emotional burden in the family was significantly associated with low religious inclination of husband and wife; strained relationship of couple; extended family pressure on husband; husbands' negative attitude towards child adoption; and lower age group of wife. Women with infertility in this subregion experience higher emotional burden than their husbands. Psychological couple counselling is required to ameliorate the emotional burden of infertility imposed by these factors.

Emotional Burden of Infertility : a Controlled Study of Women Managed at a Nigerian Teaching Hospital

The purpose of this study was to determine the relationship between socio-cultural factors and infertility-related stress among a sample of Nigerian women. The subscales of the Hospital Anxiety and Depression Scale and a schedule detailing socio-demographic and infertility-related variables were administered on women with infertility and a matched control group. The rates of significant anxiety symptoms (39.4) and depressive symptoms (40.4) among the women with infertility were higher than the corresponding rates of 11.1 and 10.1 in the control group. Their mean anxiety and depression scores were also higher (P0.001). Low religiosity; friction with husband's family; polygamous relationship and family pressure on husband predicted symptoms among the women with infertility. Public campaign to improve attitude towards women with infertility is advocated. Therapeutic mental health services are important for these women

Emotional distress and self-reported quality of life among primary caregivers of stroke survivors in Nigeria.

OBJECTIVES: To investigate emotional symptoms and domain quality of life (QOL) among primary caregivers of stroke survivors and to determine survivor-related and caregiver-related predictors of these variables. DESIGN: A cross-sectional study. SETTING: Medical units of the two major hospitals of the Obafemi Awolowo University Teaching Hospitals Complex, ile-Ife, Nigeria. SUBJECTS: One hundred and three matched-pairs of caregivers of stroke survivors and caregivers of mild hypertensive patients, and 103 stroke survivors. RESULTS: Twenty three (22.3%) and 25(24.3%) stroke caregivers were observed with clinically significant anxiety and depressive symptoms respectively compared with 12(11.7%) and 14(13.6%) subjects in the control group. Stroke caregivers were observed with significantly higher mean anxiety and depressions scores, and also, with significantly lower mean scores on the four QOL domains (physical health, psychological health, social relationships and environment). By multiple linear regression analysis, anxiety symptoms in stroke caregivers were predicted by high socioeconomic status of survivors and paresis in them. Depressive symptoms were predicted by high caregivers' age and depression in the patients. Higher QOL on one or more WHOQOL-Bref domains was predicted by intimate relationship with survivor, female gender of caregiver, longer duration of caring, higher education of survivor and higher age of survivor. Low QOL on one or more domain(s) was predicted by higher caregivers' age, carers' perception of survivor as cooperative, female gender of survivor, depression in survivor, paresis and cognitive impairment in survivor. CONCLUSION: Caregiving imposes high burden on stroke carers. Attention should be paid to their psychological needs and services should be designed for them to ameliorate the burden.

Psychological characteristics as correlates of emotional burden in incarcerated offenders in Nigeria.

OBJECTIVES: To evaluate the demographic and psychosocial characteristics of incarcerated offenders in a Nigerian prison and investigate their relationship with psychiatric morbidity. DESIGN: A cross-sectional study employing the 30 - item version of the General Health Questionnaire (GHQ-30) and the depression sub-scale of the Hospital Anxiety and Depression scale (HADS-Depression). SETTING: A medium security prison located in Ilesa, a semi-urban community in Southwestern Nigeria. SUBJECTS: Three hundred and three prison inmates. RESULTS: Out of the 352 inmates, 49 (13.9%) refused to participate in the study. There was a preponderance of male offenders (96.4%), and majority (59.3%) was awaiting trial. Thirteen inmates (4.3%) had been imprisoned before (i.e., before current imprisonment). Less than half (34%) reported enjoying good mental health in prison while 11 (3.7%) gave history of previous mental disorder before imprisonment. Majority reported the level of visitation and financial assistance by relatives and friends as poor. Also, majority reported prison accommodation and feeding as poor while less than a half of the sample were satisfied with the level of available health care. Majority of the inmates scored above the cut-off points on the measures of psychopathology. These were 87.8% and 85.3% on the GHQ - 30 and the HADS - Depression Sub-scale respectively. Significant relationship was observed between GHQ-30 'caseness' and awaiting trial status, and also with reporting current mental health; prison accommodation and prison feeding as poor. In addition, significant depressive symptoms were associated with being a Muslim or traditional religion worshipper; lower education; single, divorced or separated marital status, and appraisal of current mental health as poor. CONCLUSION: The results are largely similar to findings from the developed world. Improving living condition and provision of basic needs of the prisoners appear essential for the promotion of their mental health.