Recognition of Autism Spectrum Disorder (ASD) symptoms and knowledge about some other aspects of ASD among final year medical students in Nigeria, Sub-Saharan Africa.

BACKGROUND: Earlier studies suggest that knowledge about Autism Spectrum Disorder (ASD) among healthcare workers in Nigeria is low. This present study assessed the knowledge of Nigerian final year medical students about symptoms of ASD and some other aspects of ASD. This is a cross sectional descriptive study that drew a total of seven hundred and fifty-seven (757) final year medical students from ten (10) randomly selected fully accredited medical schools out of a total of twenty-seven (27) fully accredited medical schools in Nigeria. Sociodemographic and Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaires were used to assess knowledge of final year medical students about ASD and obtain demographic information. RESULTS: Only few, 218 (28.8 %) of the 757 final year medical students had seen and participated in evaluation and management of at least a child with ASD during their clinical postings in pediatrics and psychiatry. Knowledge and recognition of symptoms of ASD is observed to be better among this group of final year medical students as shown by higher mean scores in the four domains of KCAHW questionnaire. Knowledge about ASD varies across gender and regions. Misconceptions about ASD were also observed among the final year medical students. CONCLUSIONS: More focus needs to be given to ASD in the curriculum of Nigerian undergraduate medical students, especially during their psychiatry and pediatric clinical postings.

Self-reported sleep parameters among secondary school teenagers in middle-belt Nigeria.

BACKGROUND: Available evidences seem to suggest increasing trend in sleep deficit among teenagers worldwide, and there is limited information on this among Nigerian teenagers. This study was carried out to determine the basic sleep schedule and sleep duration among schooling teenagers in Ilorin, Nigeria. METHODS: This is a descriptive cross-sectional study conducted among 20 selected public secondary schools in Ilorin, Nigeria. A multistage sampling technique was used to randomly select participating schools. RESULT: A total of 1033 students participated in the study; of these 47.3% were males and 51.7% females. Students mean age (standard deviation) was 15.3 ± 1.6 years with a range of 12-19 years. Majority (76.2%) of participants co-share bed with at least one person and some (23.8%) slept alone in bed. The three leading reasons given for going to bed were: Tiredness - 31.1%, completion of house assignment - 20.5%, and parental directive - 12.4%. 10% of teenagers do make regular phone calls at night and 5.5% surf internet and use computers at night. Regular habits of daytime sleepiness were reported by 8.2% of study participants. Students' mean sleep duration during school days was 9.33 ± 2.29 h compared to 10.09 ± 1.32 h at weekend (P < 0.05). The duration of night time sleep was adequate (>9 h) in 41% of students; borderline (8-9 h) in 44.3% while 13.3% of the students had insufficient nighttime sleep duration (<8 h) P < 0.05. CONCLUSION: A substantial number of students had borderline nighttime sleep duration and so had potentials to transit into the problematic insufficient range. To prevent this, there is a need to educate schooling teenagers on the dangers associated with prolonged sleep insufficiency.

Psychiatric morbidity in stroke patients attending a neurology clinic in Nigeria.

BACK GROUND: Stroke produces a wide range of mental and emotional disorders. Neuropsychiatric complications associated with stroke may have negative effects on the social functioning, overall quality of life and the recovery of motor functioning of stroke survivors. OBJECTIVE: To determine the prevalence and nature of psychiatric morbidity among stroke patients attending neurology outpatient clinic of the University of Ilorin Teaching Hospital (UITH), Ilorin-Nigeria. METHODS: All patients with stroke aged 18 years and above at an outpatient neurology clinic in Ilorin, Nigeria were assessed for mental and emotional disorders using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) over one year (March 2009 to February 2010). RESULTS: Overall prevalence of psychiatric morbidity was 36.0% (30/83) among 83 patients who constituted the study population. Specific diagnoses recorded were depression (19.2%), generalised anxiety disorder (9.6%), harmful alcohol use (2.4%); dementia, somatoform disorder, phobia and delusional disorder each had a prevalence of 1.2%. Clinical and sociodemographic variables were not significantly associated with psychiatric morbidity. CONCLUSION: Psychiatric disorders are often associated with stroke. Identifying and treating stroke patients with these psychiatric co-morbidities could thus help to improve the overall quality of life of these patients.

PSYCHIATRIC MORBIDITY IN A NIGERIAN NEUROLOGY CLINIC.

OBJECTIVE: The objective of the study was to determine the prevalence and nature of psychiatric morbidity among patients attending a neurology outpatient clinic. DESIGN: A two-stage screening procedure with General Health Questionnaire (GHQ-12) and Schedules for Clinical Assessment in Neuropsychiatry (SCAN) was used to assess psychological disorders over a one year period. Psychiatric diagnosis was based on ICD-10 criteria. SETTING: University of Ilorin Teaching Hospital (UITH), Ilorin-Nigeria SUBJECTS: Two hundred and thirty-five (235) patients aged 18 years and above attending the neurology outpatient clinic. RESULTS: Overall prevalence of psychiatric morbidity was 26.0% (61/235). The most frequent diagnoses were depression (14.9%), generalised anxiety disorder (5.5%), dementia (2.6%) and substance use disorder (1.3%). Significantly more patients with stroke had psychiatric morbidity. CONCLUSION: The study supports previous reports that psychiatric disorders are quite common among patients with neurological disorders. Efforts should, therefore, be directed at identifying and treating neurological patients with psychiatric morbidity since this will ensure improved outcome. In this regard, mental health professionals would need to provide liaison services for the neurologists and train them in the use of simple screening instruments for detecting associated psychiatric disorders with appropriate referral where necessary.

Children with sickle cell disease who are experiencing psychosocial problems concurrently with their mothers: a Nigerian study.

OBJECTIVE: The objective of the study was to identify children with Sickle cell disease (SCD) who are experiencing psychosocial problems concurrently with their mothers; and comparing the dyads to determine correlation, pattern of correlation and to identify correlating or modifying factors. METHOD: The psychosocial impact of Sickle cell disease in affected children and their mothers was assessed using semi-structured questionnaire and standardized instruments (The Child Behaviour Questionnaire (CBQ) - Parents' version or Scale A2) for the children and Self Reporting Questionnaire (SRQ) for their mothers) Children with bronchial asthma and some with acute medical illnesses (AMI) and their mothers who were also assessed with the same instruments served as the control population. RESULTS: There was significant correlation between children who were probable cases with psychological problems based on Child Behaviour Questionnaire (CBQ score of ≥7) and corresponding mothers who were probable cases with psychosocial problems based on Self-Reporting Questionnaire (SRQ score of ≥5).Although there were some group-specific factors that influenced this pattern (child and mother having psychosocial problems concurrently) in one or 2 groups of these diseases, none cut across the 3 groups. CONCLUSION: In psychosocial management of physical illnesses, assessment and care should include a focus on families rather than on the affected individual only. In addition, identifying emotional and social dysfunction in a family member should lead to a search in other members; in this way primary prevention or control can effectively be carried out. Finally, identifying more modifiable factors that positively influence this pattern in which child and mother experience psychosocial dysfunction concurrently should be the urgent task of future and larger studies in this environment.

Psychological and Social Adjustment to Blindness: Understanding from two groups of Blind People in Ilorin; Nigeria

Background: Blindness can cause psychosocial distress leading to maladjustment if not mitigated. Maladjustment is a secondary burden that further reduces quality of life of the blind. Adjustment is often personalized and depends on nature and quality of prevailing psychosocial support and rehabilitation opportunities. This study was aimed at identifying the pattern of psychosocial adjustment in a group of relatively secluded and under-reached totally blind people in Ilorin; thus sensitizing eye doctors to psychosocial morbidity and care in the blind. Materials and Methods: A cross-sectional descriptive study using 20-item Self-Reporting Questionnaire (SRQ) and a pro forma designed by the authors to assess the psychosocial problems and risk factors in some blind people in Ilorin metropolis. Result: The study revealed that most of the blind people were reasonably adjusted in key areas of social interaction; marriage; and family. Majority were considered to be poorly adjusted in the areas of education; vocational training; employment; and mobility. Many were also considered to be psychologically maladjusted based on the high rate of probable sychological disorder of 51; as determined by SRQ. Factors identified as risk factors of probable psychological disorder were poor educational background and the presence of another medical disorder. Conclusion: Most of the blind had no access to formal education or rehabilitation system; which may have contributed to their maladjustment in the domains identified. Although their prevailing psychosocial situation would have been better prevented yet; real opportunity still exists to help this group of people in the area of social and physical rehabilitation; meeting medical needs; preventive psychiatry; preventive ophthalmology; and community health. This will require the joint efforts of medical community; government and nongovernment organizations to provide the framework for delivery of these services directly to the communities

Audit of child and adolescent psychiatry in a teaching hospital in Nigeria: prevalence, pattern and implication for improved services

Objective. This study aimed to identify the socio-demographic characteristics; pattern of psychiatric disorders and management of children and adolescents before the setting up of a dedicated child and adolescent unit at the University of Ilorin Teaching Hospital; Ilorin; Nigeria.Method. A retrospective study; carried out at the Department of Behavioural Sciences of the hospital.Results. The age range of the 94 children seen was 7 - 19 years; with a mean of 16.38 years (standard deviation 2.49); 82 were aged 14 - 19 years and 17 7 - 13 years; while only 1 child was under 7 years old. The majority of the children lived with their parents in monogamous families with 5 or more children. The majority of the parents were educated and gainfully employed.The major diagnoses were schizophrenia (50); delirium (15) and seizure disorders (9). Of the patients 64 were managed as outpatients and 36 as inpatients. Drug therapy was involved in the majority of cases; and the most frequently prescribed medication was haloperidol; atypical antipsychotics such as risperidone being used in only 8 of cases.Most of the patients were referred from the primary care-associated departments of the hospital; i.e. the general outpatient department (40) and the internal medicine and paediatrics departments (29). Referrals from welfare; judicial and educational institutions were uncommon (3).Conclusion. The pattern of patient presentation and management had not changed to any great extent over the past two decades. The introduction of a child and adolescent psychiatric unit is expected to improve consultation/liaison psychiatry and also child psychiatric service delivery and research. Understanding of the prevalence and pattern of presentation of mental disorders and their management is also expected to help improve the strategic planning and organisation of the new clinic

Psychosocial impact of sickle cell disease on mothers of affected children seen at University of Ilorin Teaching Hospital, Ilorin, Nigeria.

BACKGROUND: Attention paid to psychological disorders of mothers or families of children suffering from sickle cell disease (SCD) in Nigeria has been inadequate. OBJECTIVE: To assess the psychosocial impact of SCD on mothers of affected children and two control samples. DESIGN: A cross-sectional controlled study. SETTING: University of Ilorin Teaching Hospital, Ilorin, Nigeria. SUBJECTS: One hundred mothers of SCD affected children (SCD children) were the study sample while the controls were made of 75 mothers of children with bronchial asthma (asthmatics) and 75 mothers of children with some acute medical illness (AMI). RESULTS: The mothers of children with SCD (SCD mothers) were significantly likely to report burden in the areas of finance, time consumption and hindrance from enjoyment of live and were also more likely to over-protect their children. A total of 28% of SCD mothers were identified as probable cases with psychological problems on SRQ compared to 20% and 25% of mothers of asthmatics and AMI children respectively, this differences were, however, not statistically significant. CONCLUSION: As a result of the prevalent psychosocial impact of this disease on mothers it is strongly suggested that special consideration in terms of routine psychosocial assessment and treatment be incorporated into the various levels of health care system. There is also the need to encourage the establishment of more social organisations like SCD clubs where affected families can interact and counsel one another.

Psychosocial impact of sickle cell disease in children seen at University of Ilorin Teaching Hospital, Ilorin, Nigeria.

BACKGROUND: The increased risk of psychological disorders constitutes one of the complications of sickle cell disease (SCD) in Nigeria. This subject has received insufficient attention. OBJECTIVES: To assess the psychosocial impact of SCD on affected children and two control samples. DESIGN: A cross-sectional controlled study. SETTING: University of Ilorin Teaching Hospital, Ilorin, Nigeria. SUBJECTS: One hundred children affected with sickle cell disease (SCD children) consituted the study sample, while the controls comprised of 75 children with bronchial asthma (asthmatics) and 75 with some acute medical illness (AMI). RESULTS: Sickle cell disease (SCD) children (sicklers) were significantly more likely to report social impairment such as restriction in their play and domestic activities, feeling inferior to others, having bad luck, fear of under-achievement in life and fear of potential early death than the control groups. On the Rutter Scale A2, the SCD children were more likely than the controls to report neurotic symptoms but less likely than controls to bully other children. SCD children (30%) were more likely to be identified as probable cases with psychological problems than asthmatics (25%) and AMI children (20%). These differences were, however, not statistically significant. CONCLUSION: This study further substantiates earlier findings of the link between chronic childhood illnesses such as SCD and psychosocial morbidity. The authors, therefore, recommend that comprehensive and affordable psychosocial care should be provided for children suffering from these conditions.