Post-traumatic stress disorder, major depressive disorder and generalised anxiety disorder, among university students following a terrorist attack in Kenya

Background: Little research exists in Sub-Saharan Africa on the rates of mental disorders following terror attacks. Available studies have examined PostTraumatic Stress Disorder (PTSD) only. This study sought to document the burden of PTSD, Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) among survivors of the Garissa University College terror attack that occurred in North Eastern Kenya in 2015Methods: This was a retrospective chart review of medical records of students screened for psychopathology following the attack. Screening for the terror attack related PTSD, for MDD and for GAD was done using the PTSD Checklist for Diagnostic and Statistical Manual 5 (PCL-5), the Patient Health Questionnaire -9 (PHQ-9) and the Generalized Anxiety Disorder 7 – item Scale (GAD-7), respectively. Screening was conducted 7 weeks after the attack. Results: A total of 552 subjects were screened of whom 385 (69.7%) were male. Two hundred and fifty eight (46.7% [95% CI: 42.5, 50.9]) participants met criteria for a probable PTSD. Two hundred and five (37.1% [95%CI: 33.1, 41.2]) screened positive for MDD while 231 (41.8% [95%CI: 37.7, 46.0]) had probable GAD. There were high rates of co-occurrence of PTSD, MDD and GAD with 139 (25.1%) participants screening positive for all three disorders.Conclusions: The results of this study show a high mental health impact upon survivors of the attack. These findings have implications for the planning of interventions in the aftermath of terror attacks in Kenya

Factor structure and item response of psychosis symptoms among Kenyan adults

<h4>Background</h4>The aim of this study was to evaluate the construct validity of the psychosis module of the Mini International Neuropsychiatric Interview version 7.0.2 (MINI-7).<h4>Method</h4>We utilized data collected from 2738 participants with a primary psychotic or bipolar disorder. Participants were drawn from two Kenyan sites of a large multi-center neuropsychiatric genetic study. The factor structure of the MINI-7 psychosis items were explored using confirmatory factor analyses (CFA) and Item Response Theory approach, for the full sample and by gender.<h4>Results</h4>The CFA revealed that a 1-factor model provided adequate fit for the MINI-7 psychosis items for the full sample (x<sup>2</sup> = 397.92, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.92; TLI = 0.90) as well as for the female (x<sup>2</sup> = 185.16.92, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.93; TLI = 0.91) and male groups (x<sup>2</sup> = 242.09, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.92; TLI = 0.89). Item thresholds for the full sample, and female and male groups were highest for 'odd beliefs' (-1.42, -1.33, and -1.51 respectively) and lowest for 'visual hallucinations' (-0.03, -0.04, and -0.01 respectively).<h4>Limitations</h4>Our study used a hospital-based population, which may have excluded patients with milder psychotic symptoms. Findings may therefore not be generalizable to the community setting.<h4>Conclusions</h4>Our findings indicate good construct validity of the MINI-7 psychosis module, and provides support for use of the tool in diagnosing psychotic disorders in clinical settings in Kenya