Prevalence and Pattern of Psychiatric Morbidity Among Community-Dwelling Elderly Populations in Abeokuta, Nigeria.

BACKGROUND: Many elderly persons in Nigeria are having mental health challenges and there is a lack of commensurate increase in services to attend to such. AIM: To assess the prevalence, pattern and correlates of psychiatric morbidity among community dwelling elderly persons (≥ 60 years) in Abeokuta, Nigeria. METHODS: 532 respondents were selected using a multistage, stratified cluster sampling method from the elderly population in Abeokuta. First, participants were administered the socio-demographic questionnaire, General Health Questionnaire-12 (GHQ-12), and the Mini-Mental State Examination (MMSE). Those with a score of ≥ 3 in GHQ-12 were assessed with the Mini International Neuropsychiatric Interview (MINI PLUS), while those with ≤ 16 in MMSE were assessed with the Diagnostic Statistical Manual (DSM) IV criteria for Dementia and the Petersen's criteria for Mild Cognitive Impairment (MCI). RESULTS: 36.3% of the respondents had a probable psychological disorder, while 25.4% had a probable cognitive impairment. 9.8% had a current definitive psychiatric disorder. The commonest disorders were major depressive disorder and dementia. The female gender, the oldest old (≥ 80 years), having a chronic medical illness and bereavement in the last 1 year were most significantly associated with having mental health problems. CONCLUSION: A significant number of the elderly population in the studied community suffers from a psychiatric illness. It is hoped that studies as these will inform stakeholders on the need to pay closer attention to the mental health needs of the elderly, as their overall wellbeing plays a role in determining the overall health of the community.

A 10-year descriptive study of electroconvulsive therapy at the Neuropsychiatric Hospital, Aro, Abeokuta.

OBJECTIVES: Evidence supports the use of electroconvulsive therapy (ECT) in current practice, and good quality of care is related to adherence to evidence-based guidelines. However, there are no guidelines for the practice of ECT in Nigeria and there is no regulatory body for its standards. The objective of this study therefore was to examine the practice of ECT between 2001 and 2010 at the Neuropsychiatric Hospital, Aro, Abeokuta, regarding consent procedures, staffing, training, indications, and administration with the goal of informing the development of guidelines locally. METHODS: Data were extracted from 154 complete ECT treatment records in the register and from the patients' case files. The data were qualitatively analyzed and described. RESULTS: The mean age of patients who received ECT was 35.5 years and the majority were female. Bilateral electrode placement was invariable for all treatments. The major diagnosis of the patients receiving ECT was schizophrenia, whereas poor response to medication and psychomotor retardation were commonly stated indications. Treatments were largely unmodified during the first 3 years of the review, with a gradual reversal of this pattern in the latter years. The mean number of treatments per patient was 6.6, and only 1 patient received continuation ECT. CONCLUSIONS: Although the procedure of ECT in this center is generally similar to what is obtained in many other countries in Asia and Africa, aspects such as that of informed consent require attention. Regular audits of the practice are desirable.