Perceived economic and behavioural effects of the mentally ill on their relatives in Kenya: a case study of the Mathari Hospital.

OBJECTIVE: There is no documented evidence in Kenya on relatives' perceptions of economic and behavioural effects of the mentally ill patients and their coping mechanisms. To document what relatives of mentally ill patients perceive to be the economic effects of the patients on the family and how they are affected by and cope with the disturbed behaviours of the patients. METHOD: This was a cross-sectional descriptive study conducted at the Mathari Psychiatric Hospital. Informed consent was obtained from both the relatives and the patients admitted at the hospital. Data on socio-demographic and economic profiles were obtained from the patients and their relatives. The relatives were interviewed using a structured questionnaire to determine what they perceived to be the economic effects of the mental illness, how the various disturbed behaviours of the mentally ill affected them, and how they coped. The data were analysed using SPSS version 11.5 and results are presented in narratives and tables. RESULTS: One hundred and seventy-five relatives and 107 patients were recruited and interviewed. The patients were younger and better educated but economically less well off than their relatives. The relatives perceived that the mentally ill patients caused financial constraints and that various disturbed behaviours, particularly, verbal and physical aggression and refusal of the patient to take medicine or go to hospital, affected the family in different ways. Different coping mechanisms were used, depending on whether or not the behaviours were intrusive. CONCLUSION: Mentally ill patients adversely affect their families in diverse ways. There is need for appropriate policy to address the needs of families with mentally ill patients at the family and community levels. However, these must be evidence-based and this calls for further research.

Psychometric Properties of the Multidimensional Anxiety Scale for Children (MASC) amongst Nairobi Public Secondary School Children; Kenya

Background: There are few psychometric instruments whose properties have been studied in a developing country's context. Aim: To determine the psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) in Nairobi public secondary school children; Kenya. Method: Concurrent self-administration of the MASC and Children's Depression Inventory (CDI) to students in Nairobi public secondary schools. Results: The MASC had a high overall internal consistency alpha co-efficient (0.85) in the Kenyan sample; which is similar to Western findings; and is hence a reliable tool for measuring anxiety in the study population. It was also similar to the findings from two Western studies in the anxiety domains of physical symptoms; social anxiety; separation anxiety and harm avoidance. The correlation co-efficient with CDI was similar to Scandinavian findings. Conclusion: The MASC can be used in Kenyan children and; by extension; other Africa children

Psychometric Properties of the Multidimensional Anxiety Scale for Children (MASC) amongst Nairobi Public Secondary School Children; Kenya

Background:There are few psychometric instruments whose properties have been studied in a developing country's context.Aim: To determine the psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) in Nairobi public secondary school children; Kenya.Method: Concurrent self-administration of the MASC and Children's Depression Inventory (CDI) to students in Nairobi public secondary schools.Results: The MASC had a high overall internal consistency alpha co-efficient (0.85) in the Kenyan sample; which is similar to Western findings; and is hence a reliable tool for measuring anxiety in the study population.It was also similar to the findings from two Western studies in the anxiety domains of physical symptoms; social anxiety; separation anxiety and harm avoidance.The correlation co-efficient with CDI was similar to Scandinavian findings.Conclusion: The MASC can be used in Kenyan children and; by extension; other Africa children

Psychometric Properties of the Multidimensional Anxiety Scale for Children (MASC) amongst Nairobi Public Secondary School Children; Kenya

Background:There are few psychometric instruments whose properties have been studied in a developing country's context.Aim: To determine the psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) in Nairobi public secondary school children; Kenya.Method: Concurrent self-administration of the MASC and Children's Depression Inventory (CDI) to students in Nairobi public secondary schools.Results: The MASC had a high overall internal consistency alpha co-efficient (0.85) in the Kenyan sample; which is similar to Western findings; and is hence a reliable tool for measuring anxiety in the study population.It was also similar to the findings from two Western studies in the anxiety domains of physical symptoms; social anxiety; separation anxiety and harm avoidance.The correlation co-efficient with CDI was similar to Scandinavian findings.Conclusion: The MASC can be used in Kenyan children and; by extension; other Africa children

Traumatic Experiences of Kenyan Secondary School Students

Background: There is no information on the socio-demographic variations and determinants of Trauma and Post-Traumatic Stress Disorder (PTSD) in Kenyan adolescents. Objectives: To describe the traumatic experiences of Kenyan high school students and to determine the levels of Post-traumatic Stress Disorder (PTSD) among them; and in relation to sociodemographic variables. Design: A cross-sectional study of 1 110 students (629 males and 481 females); aged 12 to 26 years; using self-administered questionnaires. Method: The students completed questionnaires on sociodemographic data followed by the Trauma Checklist and the Child PTSD Checklist. Results: Being confronted with bad news was the most common type of trauma encountered in 66.7of the subjects; followed by witnessing a violent crime and domestic violence; 23.2and 16.5of the subjects reported physical abuse and sexual abuse respectively. PTSD symptoms were common; avoidance and re-experiencing occurred in 75of the students and hyperarousal was reported by over 50. The number of traumatic events was positively correlated with the occurrence of PTSD. The prevalence of full PTSD was 50.5; while partial PTSD was 34.8. Male and female subjects were equally affected but the boarders were more affected (p 0.05) and the differences between the schools were statistically significant (p

Traumatic Experiences of Kenyan Secondary School Students

Background:There is no information on the socio-demographic variations and determinants of Trauma and Post-Traumatic Stress Disorder (PTSD) in Kenyan adolescents.Objectives: To describe the traumatic experiences of Kenyan high school students and to determine the levels of Post-traumatic Stress Disorder (PTSD) among them; and in relation to sociodemographic variables.Design: A cross-sectional study of 1 110 students (629 males and 481 females); aged 12 to 26 years; using self-administered questionnaires.Method: The students completed questionnaires on sociodemographic data followed by the Trauma Checklist and the Child PTSD Checklist.Results: Being confronted with bad news was the most common type of trauma encountered in 66.7of the subjects; followed by witnessing a violent crime and domestic violence; 23.2and 16.5of the subjects reported physical abuse and sexual abuse respectively. PTSD symptoms were common; avoidance and re-experiencing occurred in 75of the students and hyperarousal was reported by over 50. The number of traumatic events was positively correlated with the occurrence of PTSD. The prevalence of full PTSD was 50.5; while partial PTSD was 34.8. Male and female subjects were equally affected but the boarders were more affected (p 0.05) and the differences between the schools were statistically significant (p

Traumatic Experiences of Kenyan Secondary School Students

Background:There is no information on the socio-demographic variations and determinants of Trauma and Post-Traumatic Stress Disorder (PTSD) in Kenyan adolescents.Objectives: To describe the traumatic experiences of Kenyan high school students and to determine the levels of Post-traumatic Stress Disorder (PTSD) among them; and in relation to sociodemographic variables.Design: A cross-sectional study of 1 110 students (629 males and 481 females); aged 12 to 26 years; using self-administered questionnaires.Method: The students completed questionnaires on sociodemographic data followed by the Trauma Checklist and the Child PTSD Checklist.Results: Being confronted with bad news was the most common type of trauma encountered in 66.7of the subjects; followed by witnessing a violent crime and domestic violence; 23.2and 16.5of the subjects reported physical abuse and sexual abuse respectively. PTSD symptoms were common; avoidance and re-experiencing occurred in 75of the students and hyperarousal was reported by over 50. The number of traumatic events was positively correlated with the occurrence of PTSD. The prevalence of full PTSD was 50.5; while partial PTSD was 34.8. Male and female subjects were equally affected but the boarders were more affected (p 0.05) and the differences between the schools were statistically significant (p

Post traumatic stress disorder among motor vehicle accident survivors attending the orthopaedic and trauma clinic at Kenyatta National Hospital, Nairobi.

OBJECTIVES: To determine the prevalence rate of post traumatic stress disorder (PTSD) and associated risk factors among motor vehicle accident (MVA) survivors attending the orthopaedic and trauma clinic at Kenyatta National Hospital, Nairobi. DESIGN: A cross-sectional study. SETTING: Kenyatta National Hospital, Nairobi. SUBJECTS: One hundred and ninety seven adult males and sixty seven female patients. METHOD: The 264 patients were interviewed using a questionnaire to collect the socio-demographic data, the Self Rating Questionnaire (SRQ) and the Impact of Event Scale-Revised (IES-R). Diagnosis was made using the Diagnostic and Statistical Manual (DSM-IV). RESULTS: The mean age was 34.63+/-12.71 years (range 18-65). Overall, the prevalence rate of PTSD was 13.3%. None of the cases had been previously diagnosed as having PTSD. Females had a higher rate of 17.9% (n = 67), compared to the males 11.7% (n=197). The majority of those with PTSD (42.9%) were young, 20 - 29 years. Other risk factors were having post-primary education (62.9%), experiencing the first motor vehicle accident (14.1%), previous psychiatric illness, and other medical illnesses. The type of accident, role/status and immediate reactions to the accident were not significant. CONCLUSIONS: PTSD following motor vehicle accidents is common. Although the MVA survivors do develop significant rates of PTSD, it is not easy to identify those at risk but some of the parameters documented in this study may help. A multi disciplinary approach is therefore essential in the management of the RTA survivors at the orthopaedic and trauma clinics if their physical and psychological needs are to be adequately addressed