Perspectives on Self-Harm and Suicidal Ideation in Nigeria: A Mixed-Methods Study of Patients, Family Caregivers, Clinicians, and the Public.

BACKGROUND: Suicide and self-harm are global disease burden that contributes significantly to years of lost life and mortality. Despite the increasing rates of suicide and self-harm in Nigeria, this topic is understudied. METHODS: A mixed-methods design was adopted. Study 1 interviewed n = 18 participants (n = 11 clinicians; n = 5 patients with a history of self-harm and suicide ideation; and n = 2 caregivers). All interviews were audio-recorded, transcribed verbatim, and analyzed using IPA. Study 2 surveyed n = 562 non-clinical sample about their tolerance toward self-harm and the data was analyzed using One-way ANOVA in SPSS. RESULTS: Study 1 qualitative findings showed substance use, perceived rejection and social isolation were considered predisposing factors for suicide and self-harm. Cultural and religious beliefs shaped help-seeking behaviours. Although Study 2 found no significant differences in demographic characteristics concerning public tolerance toward persons with a history of self-harm, 64% believed that individuals who died by suicide would face punishment after death; 51% believed that victims of attempted suicide are a source of shame to their families; and 33.8% agreed that dying by suicide is the correct behaviour. CONCLUSIONS: Patients with a history of self-harm and suicidal ideation consider family members and close friends as valuable sources of support. Due to the potential clinical implication of cultural and religious beliefs, as shown in the present study's findings, the authors recommend a co-development of culturally appropriate psychological intervention for persons with a history of self-harm and suicidal ideation to be tested in randomized control trials.

Bipolar disorders in Nigeria: a mixed-methods study of patients, family caregivers, clinicians, and the community members' perspectives.

BACKGROUND: Bipolar Disorders (BDs) are chronic mental health disorders that often result in functional impairment and contribute significantly to the disability-adjusted life years (DALY). BDs are historically under-researched compared to other mental health disorders, especially in Sub-Saharan Africa and Nigeria. DESIGN: We adopted a mixed-methods design. Study 1 examined the public knowledge of BDs in relation to sociodemographic outcomes using quantitative data whilst Study 2 qualitatively assessed the lived experiences of patients with BDs, clinicians, and family caregivers. METHODS: In Study 1, a non-clinical sample of n = 575 participants responded to a compact questionnaire that examined their knowledge of BDs and how they relate to certain sociodemographic variables. One-way ANOVA was used to analyse quantitative data. Study 2 interviewed N = 15 participants (n = 5 patients with BDs; n = 7 clinicians; n = 3 family caregivers). These semi-structured interviews were audio-recorded, transcribed, and thematically analysed. RESULTS: In Study 1, findings showed no statistically significant differences, suggesting low awareness of BDs, especially among vulnerable populations such as young people and older adults. However, there was a trajectory in increased knowledge of BDs among participants between the ages of 25-44 years and part-time workers compared to other ages and employment statuses. In Study 2, qualitative findings showed that BDs are perceived to be genetically and psycho-socially induced by specific lived experiences of patients and their family caregivers. Although psychotropic medications and psychotherapy are available treatment options in Nigeria, cultural and religious beliefs were significant barriers to treatment uptake. CONCLUSIONS: This study provides insight into knowledge and beliefs about BDs, including the lived experiences of patients with BDs, their caregivers and clinicians in Nigeria. It highlights the need for further studies assessing Nigeria's feasibility and acceptability of culturally adapted psychosocial interventions for patients with BDs.

Independent socio-demographic and clinical correlates associated with the perception of quality of life of women with postpartum depressionin North-central, Nigeria.

OBJECTIVE: Quality of life (QoL) is probably the most desired outcome of all health care policies and monitoring. This concept is seldom used on women in the postpartum, especially in the developing world. AIM: This study aimed at determining the independent socio-clinical variables associated with the perception of QoL of women with postpartum depression. METHODS: A two-stage cross-sectional procedure was used to recruit 550 participants, out of whom 531 participants completed the questionnaires with 116 participants found to have postpartum depression and were the studied population, in Nigeria. The Socio-demographic questionnaire, the Edinburgh Postnatal Depression Scale, the World Health Organization Quality of Life-Bref-26 and the Depression Module of the Structured Clinical Interview for DSM-IV axis I Diagnosis were used. RESULTS: Participants with postpartum depression had significantly poor perception of QoL in all the four domains of the WHOQoL-BREF-26. The independent socio-demographic and clinical correlate associated with poor perception for both rating of QoL and satisfaction with health was education (ß = 0.321, p < .001 and ß = 0.0326, p = .002, respectively); for physical domain [(modes of delivery) (ß = -0.28, p = .016)]; psychological domain [(age <35years) (ß = 0.391, p = .010)] and for social relationships [(complications during delivery) (ß = 0.257, p = .043)]. CONCLUSIONS: The determination of the predictors of QoL, which is an indicator of disease outcome will improve service delivery to women of childbearing age.

Relationship between quality of life and postpartum depression among women in North-Central, Nigeria

Background: Postpartum depression is a problem of public health interest and impacts negatively on the perception of quality of lifer of sufferers. Quality of life' (QoL) as an outcome measure, is scantly used on women with postpartum depression in Nigeria. The current study was designed to assess the QoL of women with postpartum depression (PPD) in a tertiary hospital in North-Central, Nigeria.Method: A two-stage cross sectional procedure was used to recruit 550 participants 6 to 8 weeks postpartum in Jos, Northcentral, Nigeria. The Edinburgh Postnatal Depression Scale (EPDS), the World Health Organization Quality of Life-BREF-26 (WHOQoL-BREF-26) questionnaire and the Depression Module of the Structured Clinical Interview for DSM-IV axis I Diagnosis (SCID) were used.Results: The studied participants were 531 out which 21.8% with postpartum depression had significantly poor perception in all the four domains of the WHOQoL-BREF-26 i.e., in the physical health (p<0.001), psychological (p<0.001), social relationships (p<0.001) and environmental (p<0.001) domains. On the whole, the overall rating of quality of life (p=0.002) and satisfaction with general health (p<0.001) were also perceived to be poor when compared to those without depression. However, regression model analysis showed that the presence of postpartum depression in a participant predicts a significant negative perception on physical and environmental domains of quality of life, but a positive prediction on the general satisfaction with health. Conclusion: Postpartum depression as a disorder of public health importance impacts on the perception of quality of life of women who suffer from it. Early detection and treatment will improve the quality of life of women with postpartum depression