A cross-sectional study on resilience, anxiety, depression, and psychoactive substance use among heterosexual and sexual minority adolescents in Nigeria

Background Mental health-related problems predispose alcohol and other psychoactive substances use as coping strategies. We assessed associations between resilience and anxiety symptoms, depressive symptoms, problematic alcohol, and multiple psychoactive substance use among sexual minority and heterosexual adolescents in Nigeria. Methods This was a secondary analysis of a subset of data generated through an online cross-sectional study conducted between 16th and 31st of October 2020. Data extracted for adolescents in Nigeria age 13–19 years were: dependent variables (alcohol use using the CAGE test, multiple psychoactive substance use, depressive symptoms using the Patient Health Questionnaire-9, and anxiety symptoms using the Generalized Anxiety Disorder-7 measure); independent variables (resilience using the Connor-Davidson resilience scale and sexual identity), and confounding factors (age and sex). Associations between dependent and independent variables were determined using multivariable logistic regression analyses after controlling for confounders. Results Of the 1419 adolescent participants, 593 (42%) were sexual minority individuals, 533 (37.6%) had high depressive symptoms, 381 (26.8%) had high anxiety symptoms, 177 (12.5%) had problematic alcohol use and 389 (27.4%) used multiple psychoactive substances. Resilience was significantly associated with lower odds of anxiety (AOR:0.96, 95% CI: 0.94–0.97, p < 0.001) and depressive (AOR:0.94, 95% CI: 0.92–0.96, p < 0.001) symptoms, problematic alcohol use (AOR:0.97, 95% CI: 0.95–0.99, p = 0.002), and multiple psychoactive substance use (AOR:0.95, 95% CI: 0.93–0.96, p < 0.001). Sexual minority adolescents had significantly higher odds of anxiety (AOR:4.14, 95% CI: 3.16–5.40, p < 0.001) and depressive symptoms (AOR:4.79; 95% CI: 3.73–6.15, p < 0.001), problematic alcohol use (AOR:2.48, 95% CI: 1.76–3.49, p < 0.001), and multiple psychoactive substance use (AOR:5.69, 95% CI: 4.34–7.47, p < 0.001). Conclusion Sexual minority adolescents and adolescents with low resilience have a higher need for interventions to reduce the risk of anxiety, depression, and the use of alcohol and other psychoactive substances

Associations between mental health and HIV status among sexual minority and heterosexual adolescents in Nigeria

BACKGROUND: We aimed to determine associations between the mental health status of adolescents by self-reported sexual identity; and to determine associations between the mental health status of sexual minority adolescents living with and without HIV. METHODS: This cross-sectional study collected data from Nigerians aged 13-19 years old using an online survey. We collected information on dependent (sexual identity) and independent (presence of depressive symptoms, generalised anxiety disorder, suicidal attempt/ideation, HIV status) study variables. A multivariate regression model determined associations between the dependent and independent variables. A second multivariate regression model was developed to establish associations between HIV status among sexual minority individuals and the dependent variables. All models were adjusted for age, sex assigned at birth and education level. RESULTS: Among 1247 respondents living in Nigeria, 497 (39.9%) identified as sexual minority individuals. Compared with their heterosexual peers, sexual minority adolescents had significantly higher odds of reporting depressive symptoms (adjusted OR (AOR): 5.54; 95% CI: 4.10 to 7.47; p\u3c0.001), high general anxiety (AOR: 3.56; 95% CI: 2.64 to 4.79; p\u3c0.001) and history of suicidal attempt/ideation (AOR: 2.95; 95% CI: 2.20 to 3.94; p\u3c0.001). Sexual minority adolescents living with HIV had significantly higher odds of high general anxiety (AOR: 2.42; 95% CI: 1.21 to 4.84; p=0.013), while those with unknown HIV status had significantly higher odds of depressive symptoms (AOR: 3.82, 95% CI: 2.78 to 5.27; p\u3c0.001), high general anxiety (AOR: 3.09; 95% CI: 2.29 to 4.17; p\u3c0.001) and suicidal attempt/ideation (AOR: 1.65; 95% CI: 1.22 to 2.24; p=0.001). CONCLUSION: Sexual minority adolescents reported poorer mental health status than heterosexual adolescents. Although there was no significant difference in the mental health status of sexual minority adolescents living and not living with HIV, sexual minority adolescents with unknown HIV status reported worse mental health than their HIV-negative peers. Sexual minority adolescents in Nigeria need comprehensive rights-based care that improves access to mental health services, and those with unknown HIV status may need both HIV and mental health screening and care

Mediating effects of psychological resilience and self-esteem on the association between early childhood adversity and depressive symptoms among adolescents in Nigeria

Background Individuals who experience early childhood adversities are at risk of developing mental health problems including depression. Psychological resilience and self-esteem can ease the impact of these childhood adversities on mental health. However, there are few studies evaluating these associations. This study aimed to determine the mediating effects of psychological resilience and self-esteem on the association between early childhood adversity and depressive symptoms among adolescents in Nigeria. Methods This cross-sectional study collected data on early childhood adversity, depressive symptoms, psychological resilience, and self-esteem from adolescents 13–19 years old between September and October 2020 using an online platform. Multivariate linear regression analysis was conducted to determine the independent variables (adverse childhood experiences, psychological resilience, and self-esteem) associated with depressive symptoms, while adjusting for age, education level completed, and sexual identity (heterosexual, sexual minority individuals). Mediation path analyses were also conducted to determine the total and direct associations between early childhood adversity and depressive symptoms, and indirect effects through psychological resilience and self-esteem. Results There were 1321 complete responses, of which 767 (58.1%) reported depressive symptoms. Depressive symptoms (B: 0.28, p < 0.001) were significantly positively associated with early childhood adversity, while psychological resilience significantly mediated the total effect of early childhood adversity on depressive symptoms. The total effect was 0.946 (p < 0.001), the direct effect was 0.846 (p < 0.001), and the indirect effect was 0.101 (p < 0.001). Conclusion Targeting efforts to build psychological resilience may reduce the risk of depressive symptoms among adolescents who grow up in an environment like Nigeria where the risk of experiencing early childhood adversity is high

A cross-sectional study on resilience, anxiety, depression, and psychoactive substance use among heterosexual and sexual minority adolescents in Nigeria

Abstract Background Mental health-related problems predispose alcohol and other psychoactive substances use as coping strategies. We assessed associations between resilience and anxiety symptoms, depressive symptoms, problematic alcohol, and multiple psychoactive substance use among sexual minority and heterosexual adolescents in Nigeria. Methods This was a secondary analysis of a subset of data generated through an online cross-sectional study conducted between 16th and 31st of October 2020. Data extracted for adolescents in Nigeria age 13–19 years were: dependent variables (alcohol use using the CAGE test, multiple psychoactive substance use, depressive symptoms using the Patient Health Questionnaire-9, and anxiety symptoms using the Generalized Anxiety Disorder-7 measure); independent variables (resilience using the Connor-Davidson resilience scale and sexual identity), and confounding factors (age and sex). Associations between dependent and independent variables were determined using multivariable logistic regression analyses after controlling for confounders. Results Of the 1419 adolescent participants, 593 (42%) were sexual minority individuals, 533 (37.6%) had high depressive symptoms, 381 (26.8%) had high anxiety symptoms, 177 (12.5%) had problematic alcohol use and 389 (27.4%) used multiple psychoactive substances. Resilience was significantly associated with lower odds of anxiety (AOR:0.96, 95% CI: 0.94–0.97, p < 0.001) and depressive (AOR:0.94, 95% CI: 0.92–0.96, p < 0.001) symptoms, problematic alcohol use (AOR:0.97, 95% CI: 0.95–0.99, p = 0.002), and multiple psychoactive substance use (AOR:0.95, 95% CI: 0.93–0.96, p < 0.001). Sexual minority adolescents had significantly higher odds of anxiety (AOR:4.14, 95% CI: 3.16–5.40, p < 0.001) and depressive symptoms (AOR:4.79; 95% CI: 3.73–6.15, p < 0.001), problematic alcohol use (AOR:2.48, 95% CI: 1.76–3.49, p < 0.001), and multiple psychoactive substance use (AOR:5.69, 95% CI: 4.34–7.47, p < 0.001). Conclusion Sexual minority adolescents and adolescents with low resilience have a higher need for interventions to reduce the risk of anxiety, depression, and the use of alcohol and other psychoactive substances

Opioid-free anaesthesia and analgesia in a sickle cell disease patient with extensive orthopaedic soft-tissue surgery

The provision of anaesthesia through techniques devoid of opioid is referred to as opioid-free anaesthesia. Both pain crisis in sickle cell (SC) disease and poor postoperative pain care worsens patient morbidity. This is a case report of a 22-year-old female SC anaemia patient, who had bilateral quadricepsplasty. Sickle Cell disease is common among individuals of African race and opioids are often abused during the out-of-hospital treatment of pain crisis. We report the case of pentazocine addiction resulting in severe bilateral quadriceps fibrosis. Thus, it was necessary to avoid opioid-based anaesthesia. A combined spinal epidural anaesthesia using magnesium adjunct was applied. The analgesic function of magnesium is linked to the blockade of the N-methyl-D-aspartate receptor. The subarachnoid block was achieved with 3.5 mL of 0.5% heavy bupivacaine (17.5 mg), while epidural anaesthesia was done with 14 mL of 0.25% plain bupivacaine (37.5 mg) and 1 mL of 2 mg/kg of magnesium, (i.e., 120 mg). After the surgery, the surgical sites were infiltrated with 10 mL of 0.25% plain bupivacaine (25 mg) on each limb. Intravenous magnesium-sulfate 5 mg/kg (i.e., 300 mg), was added to 500 mL of crystalloids to run every 4 h. Furthermore, 1 mL of 2 mg/kg magnesium, (i.e., 120 mg,) was added to the 14 mL of 0.125% plain bupivacaine to make 15 mL of magnesium–bupivacaine admixture, every 4 h. These were given for 48 h. The Visual Analog Scale pain scores reduced from 9/10 to 5-6/10 and then to 3/10 over a 6-h period and remained at or lower than 3/10 throughout the postoperative period. Adequate haemodynamics, oxygenation, hydration, warmth, and urine output were ensured. The postoperative period was crisis free