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Introduction: significant numbers of patients with epilepsy have poor knowledge of their disease. Patients' knowledge of disease is related to their success in coping with the disease and adherence to medication; which is one of the key factors that determined the success of pharmacotherapy in patient with epilepsy. In this study, we evaluate the level of knowledge of epilepsy among patient with Epilepsy in a tertiary mental health care facility. Methods: using a cross-sectional design, 410 patients with epilepsy attending general outpatient clinic of Federal Neuropsychiatric Hospital, Maiduguri in Northeastern Nigeria were sampled randomly into the study after fulfilling the inclusion and exclusion criteria. Socio-demographic, clinical and epilepsy knowledge questionnaires were used for data collection. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 18. Results: 263 (64.1%) had poor knowledge of epilepsy and 290 (70%) had less frequent seizures (having fewer than four seizure episodes in the last three months). Independent predictors of knowledge of Epilepsy were intermediate skilled employment (O.R = 2.32, P = 0.022, 95% C I = 1.13 - 4.76); semi-skilled employment (O. R = 1/85, p = 0.001, 95% C I = 1.10 - 3.12); seizure frequency (O R = 1.72, p = 0.031, 95% C I = 1.31 - 3.24). Conclusion: the level of knowledge of epilepsy among people with epilepsy was low with more than 64.1% percent of the participants had poor knowledge of epilepsy. Occupational status and seizure frequencies were independent predictors of knowledge of epilepsy. We therefore recommend psycho-educational programs be incorporated in the routine clinical care of the patients and for clinicians to pay more attention to providing information and education needs of patients.
Assuntos
Instituições de Assistência Ambulatorial , Epilepsia , Humanos , Estudos Transversais , Nigéria , ConvulsõesRESUMO
OBJECTIVES: Despite the importance of a satisfying sexual life, most patients with schizophrenia spectrum disorders do not discuss sexual issue with their clinicians. The current study seeks to determine the prevalence and socio-clinical correlates of sexual dysfunction among patients with schizophrenia spectrum disorders receiving typical and atypical antipsychotic medications. The second objective is to determine the frequency and correlates of specific sexual dysfunction (desire, arousal, erection/lubrication and orgasm) by gender and drug type using the Arizona Sexual Experience Scale. METHODOLOGY: This cross-sectional study used standardized structured interviewer based survey to assess sexual dysfunction among patients with schizophrenia that are both sexually active and inactive at a tertiary hospital in Maiduguri from December 2020 to April 2021. Participants were also assayed for prolactin using ELISA Kit for a possible association with sexual dysfunction. RESULTS: The overall prevalence of sexual dysfunction among patients with schizophrenia spectrum disorder receiving antipsychotics was 34% with patients on typical and atypical antipsychotics reporting rates of 36.8% and 24.6%, respectively. Among the typical and atypical antipsychotics, patients receiving haloperidol (40.3%) and risperidone (37.5%) reported a relatively higher frequency of sexual dysfunction compared to those receiving clozapine (18.2%). Independent correlates of sexual dysfunction were: female gender (OR = 1.89, 95% CI = 1.17-3.06; P = .010), being unmarried (OR = 1.51, 95% CI = 1.17-1.96; P = .001), pseudoparkinsonism (OR = 1.66, 95% CI = 1.02-2.69; P = .008), prolactin (OR = 2.15, 95% CI = 1.34-3.43; P = .001) and severity of illness (OR = 1.34, 95% CI = 1.03-1.75; P = .030). CONCLUSION: Sexual dysfunction is prevalent among patients with schizophrenia spectrum disorder receiving either typical or atypical antipsychotics.
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Background: Extra-pyramidal side effects, sexual dysfunctions and hyperprolactinaemia are major side effects with the use of antipsychotic medications that impede treatment adherence leading to relapse, increased cost of care and rehospitalization among patients with schizophrenia on antipsychotic medications. The study aims to compare the prevalence of extra-pyramidal side effects (EPSE), sexual dysfunctions (SD) and hyperprolactinaemia (HPRL) among patients with schizophrenia spectrum disorders on typical and atypical antipsychotic medications. The secondary aim is to determine if any associations exist between extra-pyramidal side effects, sexual dysfunctions and hyperprolactinaemia. Methodology: A cross-sectional hospital-based survey involving 209 patients with schizophrenia were interviewed with structured instruments for the assessment of sexual dysfunction, EPSE and the estimation of serum prolactin was done using Enzyme-linked Immunosorbent Assay. Frequencies and Chi-square analysis were used to compare differences in EPSE, SD & HPRL. Results: The study revealed non-statistically significant differences as a group between typical and atypical antipsychotic medication in terms of extra-pyramidal side effects, sexual dysfunction and hyperprolactinaemia. However, a significant association was observed when individual drugs were compared with haloperidol causing the highest frequency of hyperprolactinaemia (χ 2 = 14.9, P = 0.011). A significant relationship between sexual dysfunction and hyperprolactinaemia, sexual dysfunction and extra-pyramidal side effects as well as extra-pyramidal and hyperprolactinaemia was found when individual items for sexual functionin were used. Conclusion: The significant relationships between sexual dysfunction only in the domains of sexual desire and arousal with hyperprolactinaemia and extrapyramidal side effects as well as hyperprolactinaemia with extrapyramidal side effects point to a common anti-dopaminergic activity of antipsychotics via different pathways. Prospective studies among a larger sample of patients with schizophrenia are needed to unfold these relationships.
