Nigerian Journal of Psychiatry

Editorial

2016-12-01T11:54:23+00:00

No Abstract.

Arts, Politics and Mental Health

2016-12-01T11:54:28+00:00

No Abstract.

Unmet need for treatment of substance use disorders in nigeria

2016-12-01T11:54:28+00:00

Evidences indicate a high unmet need for the treatment of individuals with substance use disorders in Nigeria. This review highlighted factors that accounted for such unmet needs such as inadequate or lack of data that will drive effective intervention, dearth in the number of experts in the addiction field , inadequate infrastructure , lack of pharmacological agents needed for treatment, poor understanding of cultural factors were highlighted. In this paper, we discuss these issues, including a number of recommendations.

Keywords : Unmet Need ; Substance Use Disorders; Treatment; Nigeria

Attitudes of Nigerian Pediatricians towards referring children for psychiatric evaluation

2016-12-01T11:54:28+00:00

Background: In Nigeria due to the high level of stigmatization, children with psychiatric disorders often, first present to paediatricians. The attitude of paediatricians towards psychiatric referral can, therefore, determine how promptly, children
with psychiatric problems can access specialized care.
Aims: to determine rate of referring children for psychiatric evaluation, the reasons for not referring and the factors that influence referring children for psychiatric evaluation by paediatricians.
Methods: The questionnaire designed for the study was completed by 174 Paediatricians who attended the annual scientific conf erence of Paediatric Association of Nigeria.
Results: Not having encountered children with psychiatric disorders (78%), absence of psychiatry facilities in their area of practice (70.7%), and feeling that this could embarrass the patients (56.1%), were the major reasons for nonreferral of children for psychiatric evaluation by paediatricians while the rank of participants (p=0.002), years of practice (p=0.010), and availability of psychiatry services in the centre ( p = 0. 011 ) w e r e significantly associated with referring children for psychiatric evaluation.
Conclusion: There is need to establish child and adolescent psychiatric services in all centres where children are attended to and also improve on the exposure of medical students and trainees to psychiatry.

Key words: paediatricians, psychiatric evaluation, referral

Pentazocine dependence among sickle cell disease patients attending out patient specialist sickle cell clinic in Benin City, Nigeria

2016-12-01T11:54:28+00:00

Introduction: Sickle cell disease is a chronic disease. Severe bone pain is commonly the hallmark of clinical features. This commonly necessitates the use of analgesics especially Opioids which unfortunately have a high potential to produce dependence. The complications of dependence in patients on any psychoactive substance is huge. It is particularly very challenging in those with a long standing disorder like sickle cell disease
Objective: This study seeks to determine the prevalence of pentazocine dependence among sickle cell patients attending
specialized sickle cell disease clinic in Benin City.
Methods: This was a descriptive study with a total of 125 sickle cell disease patients recruited by purposive sampling method after consent. Data was collected with questionnaire that was pre tested among medical students of same age group. The data were presented in frequency tables, .
Results: Majority of participants (80%) were between 18 30 years. Males were over (54.4%) and the largest participants were students (59.2%). Twenty four percent of the entire population study injected themselves with pentazocine and 17.6% met the ICD-10 criteria for dependence. Majority (90.9%) of those with dependence had primacy with tendency to cause physical
harm to themselves while 63.6% had strong desire for use of the drugs. The preferred sites of administration of pentazocine in descending order by the patients was the buttock (38.7%), thigh (25.8%), upper arm (22.5%) and other sites put together
contributed 4%. Furthermore 51% o f p e n t a z o c i n e d e p e n d e n t population blamed their dependence on their relatives.
Conclusion : Pentazocine dependence is more prevalent among sickle cell disease patients than hitherto assumed. This is worsened by the easy access to this drug over the pharmacy, chemist shops and other retail medicine outlets in the country. It is hoped therefore that in the management of dependence syndrome in sickle cell patients, efforts must be made to educate both the patients and their relatives. Also there must be laws regulating the availability of this drug restricting it to medical prescriptions only.

Key words: Pentazocine, drug dependence, sickle cell disease

Pattern of psychiatric illnesses among elderly patients receiving treatment in a Neuropsychiatric Hospital in Nigeria

2016-12-01T11:54:29+00:00

Background : The Geriatric population in Nigeria is increasing in size due to improvements in health care services that have resulted in increased longevity. However relatively few studies have been conducted on the pattern of psychiatric illnesses among the elderly in this environment. More over , with changing demographics, there is a need for more information.
Objective: The objectives of this study were to: (1) examine the sociodemographic and clinical variables of patients who received treatment at the Geriatric clinic of Federal Neuropsychiatric Hospital, Benin- City and (2) examine the pattern of
psychogeriatric disorders among them.
Methods: A retrospective case note review of all patients who received treatment at the Geriatric clinic from 1st January , 2012 to 31st December, 2014 was conducted. Data extracted from the case files included biodata, Psychiatric diagnoses, number of prescribed medications, clinic attendance and comorbid medical conditions.
Results: A total of six hundred and fifty (650) patients attended the geriatric clinic during the period under review. Most (67.5%) of them were females and the ages of all patients included in the study ranged between 60-109 years with a mean age of 69.9 years (S.D = + 7.96) and median age of 69 years. Majority (91.2%) were Christians while more than half (54.9%) were employed. Forty-two percent (42.6%) of the patients were of Bini ethnicity. More than half (57.5%) were married while about a third (36.3%) were widowed. Children of subjects constituted the largest percentage (78.2%) of caregivers. The three most common psychiatric illnesses were Depression (41%), Dementia (27%) and Schizophrenia (15%). A large proportion (61.8%) of the patients attended the clinic only once or twice. Almost a third (28%) had a comorbid medical illness with hypertension being the most common medical diagnosis. About half (52%) were placed on only one psychotropic medication.
Conclusion: This study showed that depression was the commonest diagnosis among the elderly subjects reviewed followed by
dementia. Some of these patients had comorbid medical illnesses such as hypertension and diabetes. Improving the quality of geriatric services bearing in mind the most prevalent psychiatric and medical disorders in this age group will help in providing adequate care to meet the mental and physical health needs of the elderly population.

Keywords: Elderly, common psychiatric illnesses, Psychogeriatric clinic, Nigeria.

Screening for alcohol use and associated level of harm in a Primary Health Care Facility in Nigeria

2016-12-01T11:54:30+00:00

Background : Psychoactive substance use presents both economic and psychological burden to the society at large with far reaching consequences. The prevalence and pattern of substance use have been studied extensively in many settings; however, studies carried out in primary care centres which are usually the first contact of patients with health care givers are few. The level of risk for adverse effects of these psychoactive substances and treatment needs of such patients are usually not assessed. We assessed the prevalence and pattern of alcohol use and associated level of risk among patients attending a primary care centre in Nigeria.
Methods: This was a cross sectional study. Three hundred and twenty five patients were recruited using systematic random sampling at the waiting room of the primary health care centre, Okeilewo, Abeokuta. Psychoactive substance use, level of risk and treatment needs were assessed using the WHO ASSIST.
Results: Lifetime and 3-month prevalence rates of alcohol use were 51.7% and 17.9% respectively. Those who exhibited moderate and high risk for adverse effects of alcohol use were 2.8% and 0.9% respectively. All respondents who were at moderate and high health risk resulting from alcohol use (n=12) were weekly alcohol users and none of them had ever received treatment for their alcohol use. Men were significantly more likely to be weekly alcohol users in the past 3 months OR = 3.0, 95% CI (1.41- 6.20). Respondents who were of Yoruba ethnicity were significantly less likely to be weekly alcohol users in past 3 months, OR = 0.3, 95% CI (0.09-0.92) compared to other tribes.
Conclusion: In view of high prevalence of alcohol use among patients in primary care with its associated health risk, there is a need for screening and brief intervention for problem drinking in primary care in Nigeria.

Key Words: Alcohol Use, Health Risks, Access to Treatment, Primary Care

The importance of 'Group Social Support' in treatment and re-union of a declared missing paranoid schizophrenic patient with her family: A Case Report

2016-12-01T11:54:30+00:00

Development of psychiatric symptoms may pose challenges to patients and their relatives especially if such is an index problem. Paranoid symptom especially towards relation might predispose such patient to abscond from home and the where about may remain unknown for sometimes. Some may be assisted by good Samaritans while others might fell under the circumstances of criminals. Social support and medical treatment may be required to reunite some of these subjects as illustrated by this case report.

KeyWords : Paranoid Schizophrenia, Homelessness, Social support