Aggressive Behaviour and Mental Illness: A Study of in-patients at Aro Neuropsychiatric Hospital, Abeokuta

To determine the magnitude and pattern of aggressive behaviour among psychiatric in-patients and identity associated socio-demographic and clinical factors. The studywas cross-sectional in design. Among patients admitted to theNeuro-psychiatricHospital, Aro (and its Lantoro annex), Abeokuta between January 1 to December 31, 2005, those who manifested aggressive behaviour were identified. Each was evaluated by the medical team, and a questionnaire detailing socio-demographic and clinic variableswas administered on them. Atotal of 305 patients comprising 213 (69.8%) males and 92(30.2%) females were managed as inpatients during the period of the survey. Out of these, 43 patients manifested aggressive behaviour representing a rate of 13.8%. The aggressive patients consisted of 26males and 17 females, representing rates of 12.2 and 18.5 percent for the sexes respectively. Of the 11 diagnoses entered for all the patients, only 3 were associated with aggressive behaviour. These included schizophrenia, 21 patients (48.8%); bipolar manic illness, 12 patients (27.9%) and co-morbid substance use (mainly cannabis) and mental disorder, 10 patients (22.3%). Nursing personnel constituted the majority of target of aggression. Unemployment was the only socio demographic variable observed with significant positive relationship with aggressive behaviour. In addition, the commonest probable precipitants of aggressive behaviour included hallucinations, clamouring for discharge and attempting to abscond, reaction to confrontational interview, impulsivity and reaction to unmet demands. Mental health practitioners (especially nurses) should be equipped with necessary skills in managing aggressive and potentially aggressive patients.The present observationsmay be useful in raising the suspicion of care providers on potentially aggressive patients for preventive purpose.Keywords: Aggressive Behaviour,Mental Illness, South-WesternNigeria

PSYCHOSOCIAL CORRELATES OF SUBSTANCE USE AMONGST SECONDARY SCHOOL STUDENTS IN SOUTH WESTERN NIGERIA

ABSTRACTObjective: To determine the psychosocial correlates of substance use among secondaryschool students in rural and urban communities in South Western Nigerian.Design: A cross-sectional survey of secondary school students using questionnaireeliciting substance use by students (WHO drug use questionnaire) and a well designedquestionnaire on psychosocial variables.Setting: Six secondary schools selected from two local government areas in Ilesa, OsunState, South Western Nigeria.Subjects: The study population comprised of 600 randomly selected senior secondaryschool students from six schools.Results: A total of 662 questionnaires were analysed. Current stimulant use was,significantly associated with lower socio-economic status, coming from 2 polygamousfamily arid self rated poor academic performance. Current alcohol use was associatedwith being a male, polygamous family background, living alone or with friends, notbeing religious arid self rated poor academic performance. Current hypnosedatives usewas commoner in students living alone or. with friends and in those with self ratedpoor academic performance. There was also significant positive relationship betweencurrent tobacco use and the male sex, not being religious and self rated poor academicLifetime use of these substances had similar association with the psychosocial variableswith slight differences.Conclusion: The similarity between the psychosocial correlates highlighted in this studyand those reported in Previous studies from other- parts of Nigeria makes theseobservations useful enough for the planning of preventive strategies

Psychological characteristics as correlates of emotional burden in incarcerated offenders in Nigeria

Objectives: To evaluate the demographic and psychosocial characteristics of incarcerated offenders in a Nigerian prison and investigate their relationship with psychiatric morbidity.Design: A cross-sectional study employing the 30 – item version of the General Health Questionnaire (GHQ-30) and the depression sub-scale of the Hospital Anxiety and Depression scale (HADSDepression).Setting: A medium security prison located in Ilesa, a semi-urban community in Southwestern Nigeria.Subjects: Three hundred and three prison inmates.Results: Out of the 352 inmates, 49 (13.9%) refused to participate in the study. There was a preponderance of male offenders (96.4%), and majority (59.3%) was awaiting trial. Thirteen inmates (4.3%) had been imprisoned before (i.e., before current imprisonment). Less than half (34%) reported enjoying good mental health in prison while 11 (3.7%) gave history of previous mental disorder before imprisonment. Majority reported the level of visitation and financial assistance by relatives and friends as poor. Also, majority reported prison accommodation and feeding as poor while less than a half of the sample were satisfied with the level of available health care. Majority of the inmates scored above the cut-off points on the measures of psychopathology. These were 87.8% and 85.3% on the GHQ - 30 and the HADS - Depression Sub-scale respectively. Significant relationship was observed between GHQ-30 ‘caseness’ and awaiting trial status, and also with reporting current mental health; prison accommodation and prison feeding as poor. In addition, significant depressive symptoms were associated with being a Muslim or traditional religion worshipper; lower education; single, divorced or separated marital status, and appraisal of current mental health as poor.Conclusion: The results are largely similar to findings from the developed world. Improving living condition and provision of basic needs of the prisoners appear essential for the promotion of their mental health

EMOTIONAL DISTRESS AND SELF-REPORTED QUALITY OF LIFE AMONG PRIMARY CAREGIVERS OF STROKE SURVIVORS IN NIGERIA

Objectives: To investigate emotional symptoms and domain quality of life (QOL) among primary caregivers of stroke survivors and to determine survivor-related and caregiver-related predictors of these variables.Design: A cross-sectional study.Setting: Medical units of the two major hospitals of the Obafemi Awolowo University Teaching Hospitals Complex, ile-Ife, Nigeria.Subjects: One hundred and three matched-pairs of caregivers of stroke survivors and caregivers of mild hypertensive patients, and 103 stroke survivors.Results: Twenty three (22.3%) and 25(24.3%) stroke caregivers were observed with clinically significant anxiety and depressive symptoms respectively compared with 12(11.7%) and 14(13.6%) subjects in the control group. Stroke caregivers were observed with significantly higher mean anxiety and depressions scores, and also, with significantly lower mean scores on the four QOLdomains (physical health, psychological health, social relationships and environment). By multiple linear regression analysis, anxiety symptoms in stroke caregivers were predicted by high socioeconomic status of survivors and paresis in them. Depressive symptoms were predicted by high caregivers’ age and depression in the patients. Higher QOL on one or more WHOQOL-Bref domainswas predicted by intimate relationship with survivor, female gender of caregiver, longer duration of caring, higher education of survivor and higher age of survivor. Low QOL on one or more domain(s) was predicted by higher caregivers’ age, carers’ perception of survivor as cooperative, female gender of survivor, depression in survivor, paresis and cognitive impairment in survivor.Conclusion: Caregiving imposes high burden on stroke carers. Attention should be paid to their psychological needs and services should be designed for them to ameliorate the burden

Sociodemographic and Offence-related characteristics of Homicide Offenders in a Nigerian prison

Background: Research on the sociodemographic, historical and forensic characteristics of homicide continue to attract the attention of mental health professionals in developing countries owing to the ongoing debate on the relationship between homicide offences and the presence of mental illness in perpetrators. This attention is partly due to the potential of these variables to be risk factors for homicide offences. There is a need to update available information in Nigeria. Aim: The study was carried out to evaluate socio-demographic and certain homicide- related characteristics of homicide defendants and to determine the relationship between socio-demographic variables and charge of homicide. Method: A questionnaire consisting of socio-demographic and homiciderelated items were administered on 66 homicide defendants at Ilesa prison, Nigeria. The socio-demographic questionaires were also administered on 66 other prisoners, as control. Results: The homicide offenders consisted of 63 (95.5%) males and 3 (4.5%) females. Most of them (78.8%) were less than 40years old. Most of the victims (72.7%) were males. In 81.8% of cases, the victims were known to the defendants. The commonest method of homicide was the use of sharp objects (27.3%) followed by the use of firearms (21.2%). Marital status, level of education and type of religion were not observed to be statistically different between the two groups. Even though, most respondents belong to less skilled occupational groups, the homicide defendants were significantly more represented in these groups and they were significantly more unemployed. Conclusion: The observations indicate that some level of restriction needs to be imposed on acquisition of dane-guns and call for concerted effort to tackle the interrelated problems of unemployment, poverty, and idleness in the society

Homicide and Psychoactive Substance use among Offenders in a Nigerian Prison.

Background: Information from previous reports tend to suggest that drug use is associated with crime, particularly with homicide offences. Data on drug use among homicide offenders are scarce in Nigeria. Aim: The study was carried out to determine the relationship between psychoactive substance use and homicide. Method: All the 66 homicide offenders in a Nigerian prison and 66 matched control prisoners, charged for nonviolent offences were studied. Information on socio-demographic variables and drug use was obtained from all the respondents by interview. Results: Before imprisonment, the homicide offenders reported the use of alcohol, cannabis and stimulants with rates of 34.6%, 15.2% and 1.5% respectively. During imprisonment, lower rates of use were reported forthese substances. These were 6.1% 1.5% and 6.1% respectively. The consolidated drug use rate among the non-violent prisoners (74.2%) wassignificantly higher than for the homicide defendants (53.0%), before imprisonment (

POST PARTUM EMOTIONAL DISTRESS IN MOTHERS OF PRETERM INFANTS: A CONTROLLED STUDY

ABSTRACTObjectives: To investigate whether mothers of preterm infants experience morepsychological distress than mothers of normal full term infants in the immediatepostpartum period.Design: Cross sectional prospective study of postpartal women using the Beck DepressionInventory(BDI) and the GHQ-30.Setting: Neonatal intensive care units and the obstetric units of Wesley Guild Hospital,Ilesa or Multipurpose Health Centre, Ilesa(These are component Units of ObafemiAwolowo University Teaching Hospitals Complex, Osun State Nigeria).Results: Of the 60 postnatal women recruited into the study, 33 mothers of pretermneonates formed the index group and 27 mothers of full term normal infants constitutedthe control group. More mothers of preterm neonates(27.3%) had GHQ-30 scores whichcategorised them as having significant emotional distress than mothers of full termnormal infants(3.7%). Similarly more mothers of preterm neonates(15.1%) were moredepressed than mothers of full term normal infants(3.7%). These differences were foundto be statistically significant when the mean scores of the two groups on the instrumentswere compared.Conclusion: These problems are not usually detected nor appropriately referred by thepaediatrician/obstetrician to the psychiatrist. This has a number of implications forpreventive psychiatry. A multidisciplinary approach is therefore essential in the detectionand management of these problems

Post partum emotional distress in mothers of preterm infants: a controlled study

Objectives: To investigate whether mothers of preterm infants experience more psychological distress than mothers of normal full term infants in the immediate postpartum period. Design: Cross sectional prospective study of postpartal women using the Beck Depression Inventory(BDI) and the GHQ-30. Setting: Neonatal intensive care units and the obstetric units of Wesley Guild Hospital, Ilesa or Multipurpose Health Centre, Ilesa(These are component Units of Obafemi Awolowo University Teaching Hospitals Complex, Osun State Nigeria). Results: Of the 60 postnatal women recruited into the study, 33 mothers of preterm neonates formed the index group and 27 mothers of full term normal infants constituted the control group. More mothers of preterm neonates(27.3%) had GHQ-30 scores which categorised them as having significant emotional distress than mothers of full term normal infants(3.7%). Similarly more mothers of preterm neonates(15.1%) were more depressed than mothers of full term normal infants(3.7%). These differences were found to be statistically significant when the mean scores of the two groups on the instruments were compared. Conclusion: These problems are not usually detected nor appropriately referred by the paediatrician/obstetrician to the psychiatrist. This has a number of implications for preventive psychiatry. A multidisciplinary approach is therefore essential in the detection and management of these problems. (East African Medical Journal: 2003 80(6): 289-292

Constraints to Youths’ involvement in Agricultural Production in Kwara State, Nigeria

The study examines the constraints to rural youth involvement in agricultural Production in Kwara State, Nigeria. A total of one hundred and twenty (120) respondents were selected using a multi-stage cluster random sampling technique. Ten school respondents each were selected from twelve farming communities in the area. The major constraints hindering youth participation in agriculture were identified as inadequate credit facility (X=2.883), lack of agricultural insurance (M.S= 2.667), poor returns to agricultural investment (X=2.667), lack of basic farming knowledge (X=2.567) and lack of access to tractors and other farm inputs. The chi-square showed relationship between the constraints and inadequate credit facility (x2-7.12), as well as lack of basic farming knowledge (x2-7.48). The study recommended provision of credit facilities with less stringent procedures and resuscitation of Agricultural Training Centres across the State to enhance youth’s participation in agriculture