Self-esteem following maxillofacial and orthopedic injuries: preliminary observations in sub-Saharan Africans.

BACKGROUND: The face is a vital component of one's personality and body image while extremities are important in function (mobility, routine daily activities). Recovery and rehabilitation from acquired maxillofacial and orthopedic traumas are psychological in nature. METHODS: This was a prospective study of recruited subjects in a Nigerian University teaching hospital. A total of 160 participants (80 with maxillofacial injuries and 80 with orthopedic injuries) had repeated review assessments within 1 week of arrival in the hospital (time 1), 4-8 weeks after initial contact (time 2), and 10-12 weeks thereafter (time 3), using Rosenberg's Self-Esteem Questionnaire. RESULTS: Thirty-three (41.3%) participants in the maxillofacial injured and 12 (15.0%) in the orthopedic injured subjects scored between 0 and 14 at time 1. At time 2, 39 (51.3%) subjects in the maxillofacial fracture group and 20 (29.0%) in the orthopedic injured group scored between 0 and 14, while at time 3, 7 (9.2%) in the maxillofacial fracture group and 1 (1.5%) in the orthopedic injured group scored between 0 and 14. There was a statistical significant difference between the two groups when compared at times 1, 2, and 3 with p < 0.001, p = 0.006, and p = 0.041 respectively. Subjects with maxillofacial fracture consistently had lower self-esteem compared to subjects with orthopedic injured for times 1, 2, and 3. CONCLUSIONS: Self-esteem may be reduced following maxillofacial injuries; therefore, measures should be taken by surgeons to minimize the risk of facial scarring by careful handling of tissues. Also, management of these injuries should integrate multidisciplinary care that will address psychological needs of patients. TRIAL REGISTRATION: Not applicable.

Comparative study of anxiety and depression following maxillofacial and orthopedic injuries. Study from a Nigerian University Teaching Hospital.

This study hopes to compare levels of anxiety and depression in the maxillofacial and orthopedic injured patients over a period of 12 weeks. This was a prospective, repeated measure design. A total of 160 participants (80 with maxillofacial and 80 with long bone fractures) had repeated review follow-ups within 1 week of arrival in the hospital (Time 1), 4-8 weeks after initial contact (Time 2) and 10-12 weeks thereafter (Time 3), using hospital anxiety and depression scale questionnaire. Road traffic accident remained the main cause of injury in both groups of subjects. The Hospital anxiety and Depression scale detected 42 (52.5%) cases of depression at baseline, 36 (47.4%) cases at Time 2, and 14 (18.4%) cases at Time 3 in the maxillofacial injured group. In the long bone fracture subjects, 47 (58.8%) cases were depressed at baseline, 23(33.3%) cases at Time 2, and only 5 (7.2%) cases at Time 3. Both groups showed reduction in depression levels with time. Fifty-six (70.0%) had anxiety at baseline, 32 (42.1%) at Time 2, and only 9 (11.8%) had anxiety at Time 3 in the maxillofacial fracture group, whereas in the long bone fracture group, 69 (86.3%) subjects were anxious at baseline, 32 (46.4%) at Time 2, and 22 (31.9%) at Time 3. There were significant differences in depression and anxiety level in both the maxillofacial and the long bone fracture subjects at baseline (Time 1), Time 2(4-8 weeks) and Time 3(10-12 weeks).

Stigmatising attitudes towards the mentally ill: a survey in a Nigerian university teaching hospital

Background. The burden of mental illness is particularly severe for people living in low-income countries. Negative attitudes towards the mentally ill; stigma experiences and discrimination constitute part of this disease burden.Objective. The aim of this study was to investigate knowledge of possible causes of mental illness and attitudes towards the mentally ill in a Nigerian university teaching hospital population.Method. A cross-sectional descriptive study of a convenience sample of 208 participants from the University of Uyo Teaching Hospital; Uyo; Nigeria; using the Community Attitudes towards the Mentally Ill (CAMI) scale. Information was also obtained on beliefs about possible causes of mental illness.Results. The respondents held strongly negative views about the mentally ill; mostly being authoritarian and restrictive in their attitudes and placing emphasis on custodial care. Even though the respondents appeared to be knowledgeable about the possible role of psychosocial and genetic factors in the causation of mental illness; 52.0 of them believed that witches could be responsible; 44.2 thought mental illness could be due to possession by demons; and close to one-third (30) felt that it could be a consequence of divine punishment.Conclusions. Stigma and discrimination against the mentally ill are widespread even in a population that is expected to be enlightened. The widespread belief in supernatural causation is likely to add to the difficulties of designing an effective antistigma psycho-educational programme. There is a need in Nigeria to develop strategies to change stigma attached to mental illness at both institutional and community levels

Psychological complications of maxillofacial trauma: preliminary findings from a Nigerian university teaching hospital.

PURPOSE: This study sought to determine 1) the prevalence of psychological distress in a series of subjects who sustained maxillofacial injuries and 2) temporal changes in psychological functioning over 12 weeks compared with baseline values. PATIENTS AND METHODS: This was a prospective, repeated-measures design study of consecutively recruited subjects at a Nigerian university teaching hospital. A total of 51 subjects with facial injuries had repeated follow-up assessments (10 days, 6 to 8 weeks, and 10 to 12 weeks) after the trauma, using standard instruments. RESULTS: The General Health Questionnaire identified a high prevalence of psychological morbidity in the subjects (90%), with 41.2% and 11.8% scoring above threshold values on the hospital anxiety and depression scales, respectively. Five subjects satisfied the criteria on the Trauma Screening Questionnaire for a diagnosis of post-traumatic stress disorder during the follow-up period. Psychological distress (General Health Questionnaire caseness) remained at high levels during the 2 follow-up assessments. CONCLUSIONS: The management of facial injuries should integrate a multidisciplinary approach that addresses the psychological needs of the patients in both the short term and the long term.