Aggressive behaviour among in-school adolescents in a developing country: patterns and associated factors.

OBJECTIVES: This study aimed to determine the pattern of aggression among senior secondary school students in Calabar and the psychosocial factors that are associated with it. METHODS: A descriptive cross-sectional study of 453 randomly selected senior secondary school students utilizing a self-administered Socio-demographic questionnaire obtain data regarding age, gender etc. and a brief interview using the Modified Overt Aggression Scale (MOAS) to determine aggression. RESULTS: The mean weighted MOAS score was 26.94 ± 0.02. Males had significantly higher weighted MOAS total score than females (t=6.466, p<0.001). There was no gender difference in their aggression against objects but the older adolescents scored higher than the younger ones (t=2.029, p=0.043). Males scored higher in verbal aggression (t=3.064, p=0.002) and physical aggression (t=7.002, p<0.001). In the aggression against self-domain, females scored higher than males (t=1.961, p=0.050). All the domains of aggression correlated positively with the total weighted MOAS score, the strongest being with physical aggression (r=0.908, p=0.000). CONCLUSIONS: Gender appears to play a significant role in aggression among the participants. That females scored higher in aggression to self may have implications for prevention of suicide among youths.

Dependent Personality, Mindful Awareness, and Marital Satisfaction and their Association with Postpartum Psychological Distress in Two Tertiary Hospitals, Southeast Nigeria.

This study assessed dependent personality, marital satisfaction, and mindful awareness and their association with postpartum depression and anxiety. It was a cross-sectional study of nursing mothers, within 6-14 weeks postpartum, at the postnatal and children's welfare clinics of two tertiary hospitals in Enugu, southeastern Nigeria. The nursing mothers responded to different questionnaires that measure each of these variables. Correlations and multiple regression analyses were used to measure the strength of association between the variables in the study and to identify predictors for the outcome variables of interest, respectively. Low mindful attention awareness, poor marital satisfaction, and low dependency predicted an increased risk of postpartum depression and anxiety, with low mindful attention awareness as the strongest predictor. The findings from the study carry significant implications for the roles of dependent personality, marital satisfaction, and mindful awareness in the etiology of postpartum depression and anxiety in Southeast Nigeria.

Socio-demographic correlates of postpartum psychological distress among apparently healthy mothers in two tertiary hospitals in Enugu, South-East Nigeria.

BACKGROUND: Postpartum depression and anxiety could cause poor mother-infant relationship that could impair infant growth and cognitive development. Psychiatric assessment has not been part of periodic evaluations in postnatal clinics. Some apparently well, but high-risk mothers continue to live with psychological distress, without treatment to relieve their burden. OBJECTIVES: The study assessed the prevalence of postpartum anxiety and depression, their co-morbidity, and socio-demographic predictors, within 6 - 14 weeks postpartum among nursing mothers in two tertiary hospitals in Enugu, South-East Nigeria. METHODS: A cross-sectional study that was carried out at the postnatal and children's welfare clinics of two tertiary hospitals in Enugu, South-East Nigeria. Hospital Anxiety and Depression Scale, Social Support Scale and Socio-demographic Questionnaire were used for the study. Correlations and multiple regressions were used to test for associations and risk factors. RESULTS: Occurrence rate for anxiety and depression were 30.1% and 33.3% respectively with a co-morbidity rate of 22%. Low social support and multigravida predicted risk factors for postpartum psychological distress, while a higher number of children alive predicted a decrease in the risk for postpartum psychological distress. CONCLUSION: The study supports service planning and the development of strategies to reliably identify women at high-risk, for effective treatment.

Somatization disorder among adolescents in southeast Nigeria: a neglected issue.

BACKGROUND: Adolescents do present with somatization disorder which is often neglected by pediatricians. This could have serious consequences if not curbed early. OBJECTIVES: This study is aimed at determining the pattern and types of Somatization disorder among adolescents attending secondary schools in south east Nigeria. METHODS: Somatization disorder was investigated among 485 adolescents from mixed schools using a stratified random sampling of adolescents from four secondary schools in southeast Nigeria. The Enugu somatization scale was used to evaluate for presence of somatization in the participants. Statistical analysis was with statistical package for social sciences (SPPS) version 19 (Chicago IL). RESULTS: A total of 485 adolescents aged 10-19 years were included in this study. The mean age of the respondents was 16.36 with standard deviation (SD) of 3.14 years. Two hundred and fifty-one (51.8%) had head features, 262 (54.0%) had body features, 303 (62.5%) had either head or body features while 210 (43.3%) had both head and body features. One hundred and thirty-four males (51.3%) compared to 117 females (52.2%) reported symptoms consistent with head symptoms (p = 0.038). One hundred and eleven males (42.5%) compared to 99 females (44.2) reported symptoms related to the head and body (p = 0.137) while 135 males (51.7%) compared to 127 females (56.7%) reported symptoms related to the body (p = 0.925). There were significant associations of age in categories with head, body, either head or body as well as both head and body features (all p value <0.001). CONCLUSIONS: Psychosomatic problems do exist and may be on the rise among adolescents.

Clinical Correlates of Treatment Response among Patients with Schizophrenia in a Tertiary Nigerian Hospital.

A significant proportion of patients treated for schizophrenia respond poorly to medication. Few studies have systematically examined the impact of clinical characteristics of patients to antipsychotic response in our environment. The study aimed to identify clinical variables associated with response in patients with schizophrenia. A total of 172 participants diagnosed with schizophrenia, placed on antipsychotics, who presented for the first time to the hospital or have stopped medication in the preceding six months, whose responses were assessed after four to six weeks were studied. Improvement was defined as 20% or greater reduction in PANSS scores. Good response was associated with good medication adherence, good pre-morbid functioning, fewer negative symptoms, less cognitive impairment, absence of co-morbid personality disorder, and short duration of untreated psychosis. Due consideration of the impact of clinical variables could help detect poor responders early, hence avoiding unnecessary exposure to ineffective treatments and their side effects while effective interventions are delayed.

Psychosomatic problems among medical students: a myth or reality?

BACKGROUND: Medical students are exposed to stress and this can predispose them to psychological and behavioral consequences. METHODS: Psychosomatic disorders were investigated among 385 medical students from two teaching hospitals using a stratified random sampling. The Enugu somatization Scale (ESS) was used to evaluate for presence of somatization in the participants. Statistical analysis was done with the Statistical Package for Social Sciences (SPPS) version 19 (Chicago IL). RESULTS: A total of 385 medical students with a calculated mean age of 23.55 ± 3.33 years were recruited in this study. The prevalence of psychosomatic disorder was 55 (14.3%) with prevalence among males 33 (14.2%) and among females 22 (14.4%). Based on features, 44 (11.4%) had head features while 30 (7.8%) had body features of psychosomatic disorder respectively. Similar proportion of both males and females (about 14% each) had psychosomatic disorder. There was no statistically significant difference ([Formula: see text] = 0.002, p = 0.966). Students aged 24 years and below had similar proportion of psychosomatic disorder 38 (14.3%) with those aged over 24 years 17 (14.2%). The difference was not statistically significant ([Formula: see text] = 0.002, p = 0.964). Students from lower social class had lower proportion of psychosomatic disorder (10.6%) when compared to middle (17.2%) and upper (15.2%). The difference was equally not statistically significant ([Formula: see text] = 1.759, p = 0.415). Male students had similar likelihood of psychosomatic disorder with females (OR 1.01, 95% CI 0.56-1.82). Those had belong to middle socio-economic class were about 1.2 times (AOR 1.15, 95% CI 0.54-2.45) and lower socio-economic class about 0.6 times (AOR 0.66, 95% CI 0.31-1.37) likely to have psychosomatic disorder than those from upper socio-economic class. CONCLUSIONS: Psychosomatic disorders constitute an emerging mental health problem among medical students in Nigerian Universities. This can pose a major mental health problem if neglected.

Relationship between religiosity, religious coping and socio-demographic variables among out-patients with depression or diabetes mellitus in Enugu, Nigeria.

BACKGROUND: Religion is a powerful coping strategy. Diabetes and depression are common conditions in our environment that induce psychological distress, thus requiring coping for better outcome. Studies indicate that increased religiosity is associated with better outcome in clinical and general populations. Therefore, studies of the distribution of religiosity and religious coping among these populations are essential to improve outcome. OBJECTIVES: To assess the association between religiosity, religious coping in depression and diabetes mellitus, and selected sociodemographic variables (age, gender and occupational status). METHODS: Using simple random sampling we recruited 112 participants with diabetes and an equal number with depression consecutively, matching for gender. Religiosity was determined using religious orientation scale (revised), religious coping with brief religious coping scale and socio-demographic variables with a socio-demographic questionnaire. RESULTS: Intrinsic religiosity was greater among older people with depression than among older people with diabetes(t=5.02,p<0.001); no significant difference among young people with depression and diabetes(t=1.47,p=0.15).Positive religious coping was greater among older people with depression than among older people with diabetes(t=2.31,p=0.02); no difference among young people with depression and diabetes(t=0.80,p=0.43). Females with depression had higher intrinsic religiosity scores than males with depression(t=3.85,p<0.001); no difference in intrinsic religiosity between females and males with diabetes(t=0.99,p=0.32).Positive religious coping was greater among participants with diabetes in the low occupational status(t=2.96,p<0.001) than those in the high occupational status. CONCLUSION: Religion is indeed a reliable coping method, most commonly used by the elderly and females with depression. Positive religious coping is more common among diabetic patients who are in the low occupational status.

Determinants of Noncompliance to Clinic Appointments and Medications among Nigerian Children with Epilepsy: Experience in a Tertiary Health Facility in Enugu, Nigeria.

Purpose. To determine the frequency and determinants of noncompliance to clinic appointment and medication among Nigerian children with epilepsy. Method. This is a cross-sectional survey of noncompliance to clinic appointments and medication among 113 consecutive children with epilepsy attending the Paediatric Neurology Clinic of University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Results. Noncompliance to clinic appointment and medication was 23% and 15.3%, respectively. The major reasons given were lack of finance, clashing with school time, and forgetting to take the drugs. Children whose mothers were less educated and unemployed were more likely to miss clinic appointments. Noncompliance to medication was associated with poor seizure control. Children that were on phenobarbitone were more likely to be noncompliant with medication than those on sodium valproate and/or carbamazepine. Conclusion. Missed clinic appointment and medication noncompliance are common among Nigerian children with epilepsy and financial constraint is the most common reason.

Socio-demographic correlates of treatment response among patients with schizophrenia in a tertiary hospital in South-East Nigeria.

BACKGROUND: Many patients with schizophrenia respond poorly to antipsychotic medication. Few studies have systematically examined the relationship of social and demographic characteristics of these patients to treatment response in our environment. OBJECTIVE: To identify the social and demographic variables associated with treatment response in patients with schizophrenia. METHOD: A total of 172 participants with a diagnosis of schizophrenia receiving antipsychotics took part in the study. Participants were consecutively recruited involving patients presenting for the first time, or relapsed patients who had stopped antipsychotics in the previous six months. Both in-patients and out-patients who met the inclusion criteria were studied. Socio-demographic interview schedule and the Positive and Negative Syndrome Scale (PANSS) were administered at the initial encounter and between 4 and 6 weeks, subsequently. RESULTS: Defining good treatment response as ≥ 20% reduction in PANSS score, 68% had a good response while 32% had poor response. Good response to treatment was associated with late age of onset of illness, satisfactory family relationship, acquisition of skilled occupation and being married. However, there was no association between treatment response and gender. CONCLUSION: Knowledge about these variables in relation to treatment response would improve mental health services as regards articulation of prognosis and psycho education.

The socio-demographic characteristics and patterns of help-seeking among patients with schizophrenia in south-east Nigeria.

A large proportion of psychiatric patients in Nigeria seek help from other sources which ultimately lead to treatment delay. Treatment delay could have deleterious effects on treatment outcome especially for people with schizophrenia. The study aimed to determine the socio-demographic characteristics associated with treatment delay in people with schizophrenia. This was a cross-sectional study of 367 patients with schizophrenia presenting for the first time at a psychiatric hospital. About 76% of them had visited traditional/faith healers as a first treatment option. Long distance and use of traditional healers as first treatment option were associated with treatment delay. There is need for effective community psychiatry service delivery with emphasis on those strategies that can educate, influence, and mobilize communities concerning the aetiology, prevention, early detection, and treatment of mental illness.

Co-Morbidity of attention deficit Hyperactivity Disorder (ADHD) and epilepsy In children seen In University of Nigeria Teaching Hospital Enugu: Prevalence, Clinical and social correlates.

AIMS AND OBJECTIVES: To determine the prevalence of ADHD, epilepsy co-morbidity and social and clinical correlates in Nigerian children. PATIENTS AND METHODS: A cross-sectional study of 113 children with epilepsy was carried out and assessed for ADHD prevalence using the home version of the ADHD Rating Scale IV. The presence of certain variables occurring in association with the co-morbidity was also determined. RESULTS: Sixteen (14.2%) children had ADHD, epilepsy co-morbidity. The inattentive subtype of ADHD was the most common (68.8%). The factors that were significantly associated with the co-morbidity were poor academic performance (p=0.01), living in rural areas (p=0.00), history of status epilepticus (p=0.00) and the presence of other associated neurological pathologies (p=0.00). CONCLUSION: Children with the co-morbidity are more likely to be those that are underachieving academically, with history of status epilepticus, family history of epilepsy, and abnormal EEG. Children with the co-morbidity should be actively sought after and managed accordingly.