A study of the utilization of cough syrups containing codeine among drug abusers in Askira-uba local government area of Borno state Nigeria.

The Directorate of Narcotic and Controlled substances of the National Agency for Food and Drug Administration and control (NAFDAC) disclosed that a large number of Nigerians are abusing prescription of codeine. Objective: The following work study the illicit use of cough syrup within Askira Uba Local Government Area of Borno State of Nigeria, with the aim of understanding the sociodemographic factors surrounding the phenomenon within the study community. Methods: A questionnaire based survey was conducted within the study area. Volunteers numbering 83 were recruited from pharmaceutical premises that consented to participate in the study within the Local Government Area. The questionnaire basically addressed the sociodemographic characteristics of users of cough syrups containing codeine (CCCS) and other circumstances surrounding the usage. Data obtained were analysed using simple descriptive statistics. Results: Most of the volunteers recruited turned out to be males (n= 73, 90.1%), aged between 20 to 30 years (n=51, 63.0 %) with substantial proportion having senior secondary school certificates as the highest educational attainment (n= 26, 32.2 %). Most respondents uses 1 to 3 bottles per day (n=77, 95.1%). Feeling of euphoria appeared to be the most popular goal of abusing CCCS (n=31, 38.3%) despite the weaknesses and discomfort that alwaysfolloweda session or its absence. Conclusion: CCCS use in Askira Uba is essentially a youthful male problem that appears to be a consequence of search for happiness and excitement

Burnout syndrome and depression among healthcare professionals in Maiduguri tertiary hospitals

Working in the Healthcare sector entails intensive work both physically and psychologically can exert intense psychological and physical pressures. The negative consequences of the stress associated with work in the health care sector pose serious problems not only to the caregivers but also to the quality of patient care. Defining the extent of this problem has value for the health worker and the patients overall well being. Objective: Determine the prevalence of Burnout Syndrome Depression among clinical staff and non-clinical staff in two tertiary hospitals in Maiduguri. Method: It is a comparative study to assess the prevalence of burnout syndrome and depression among clinical and non clinical staff in tertiary health institutions in Maiduguri. Data was collected using the Becks depression inventory and the Mashlach burnout inventory. Results: A total of 420 respondents were recruited for this study with both groups being matched for age and sex. A relatively high level of burnout was observed among the clinical staffs compared to the non clinical (21.5% versus 12.5%; χ =5.31, DF=185 p=0.021). Depression was however, found to be insignificantly higher among the clinical staffs (Twenty 20 (10.7%) vs. 14 (7.6%); χ2=1.096, DF=1, p-value 0.295). There was a significant 2relatedness between having burnout and depression (χ =7.238, DF=1, p=0.007). Conclusion: Burnout syndrome and depression are common among clinical staffs and there is relationship between depression and burnout syndrome. The negative consequences of this combination which is work related can have impact on the outcome of patient management. Findings call for detection and prevention of burnout syndrome among healthcare professionals in order to protect their wellbeing and that of the healthcare industry

Attitude towards psychiatric treatment and referral pattern in the University of Maiduguri Teaching Hospital- A preliminary report

Objective: There is a paucity of literature on consultation-liaison psychiatry, in northern Nigeria. This study aimed to determine both the pattern of psychiatric referrals, and the attitudes of doctors toward the treatment of mental disorders in a teaching hospital, in northeast Nigeria. Method: In this cross-sectional survey, we used a modified version of the self-rated Kumar 12-item questionnaire and a basic socio-demographic questionnaire to assess a non-random convenient sample of 100 postgraduate resident doctors (with a response rate of 70%) from the University of Maiduguri Teaching Hospital (UMTH). We subjected the dataobtained to descriptive statistical analysis, using EPI info (2003), to report averages. Results: A relatively low percentage (57.1%) of doctors acknowledged treating patients with mental disorders in their practice, with a higher proportion acknowledging referral (75%). Nearly one in five (17.6%) of the respondents were unaware that patients with functional illness could have psychological disorders. We found more awareness for psychotherapy (44.1%) than other non-pharmacological treatment interventions, while10.3% were ignorant of non-pharmacological forms of treatment for psychological problems. Conclusion: Although this is a preliminary report, the research reported here demonstrated that doctors in the teaching hospital concerned recognized the need for psychiatric consultation and referral. It is difficult to draw further conclusions because of the limitations of this study.Keywords: Consultation; Liaison; Psychiatry; northern Nigeri

Factors Associated with Depression among Out-Patients attending a Neuro-Psychiatric Clinic in Maiduguri, Nigeria

Background: Depression, by the turn of the decade, is expected to be the leading cause of burden due to disease. An understanding of the burden of the disorder in a psychiatric hospital setting will help in allocating human and other resources required for effective management of the disorder.Aims: to determine the proportion of patients in the out-patient unit of the FNPH Maiduguri who are being managed for depression and the socio-demographic factors associated with depression.Methods: It is a retrospective study of all the patients attending the outpatient clinic of the Federal Neuropsychiatric Hospital Maiduguri from the 1st of January 2008 to 31st December 2012. Included were case notes of all patients diagnosed with depression, having adequate information. Adequate information is defined as complete bio-data, including diagnosis and treatment regiment.Results: A total of 26, 374 patients attended the clinic, and of these, 1369 were diagnosed with depression. The average age at presentation was 34. 5 years. The male to female ratio is 1:2. Factors significantly associated with depression were, sex (n= 935, 68% vs 434, 32%; p<0.001), literacy (n= 811, 59.2; p<0.001) occupation (n=913, 66%; p<0.001).Conclusion: depression is common presentation in the outpatient clinic. Social factors are significantly related with being depressed. Social treatment should also form part of the therapy.Key words: Associated factors, depression, out-patient clinic, Maidugur

An investigation into the genetic relationship between bipolar affective disorder and (idipathic) epilepsy in a sub-sahran African population

Bipolar affective disorders and epilepsy have been linked by investigations concerning their phenomenology, neuro-biology and pharmacotherapy. One large Epidemiological study revealed that bipolar symptoms occurred in 12% of community-based epilepsy patients, a rate of about seven times higher than normal controls. Little is known however, if these observations are epiphenomena of an underlying genetic substrate, the establishment of which is an important step in the understanding of these disorders, such that we can predict, prevent and effectively manage them. Objective: To determine if there is a probable genetic relationship between bipolar affective disorder and epilepsy. Method: A case control study assessing the prevalence of epilepsy among the first degree relatives of patients with bipolar affective disorder and the prevalence of bipolar disorder among first degree relatives of patients with epilepsy compared to normal controls. Results: A total of 150 patients attending the outpatient clinic between March and July 2006 were recruited for the study (40 bipolar, 60 epileptics and 50 health controls). It revealed a significantly high prevalence of epilepsy among the first degree relatives of bipolar patients compared with healthy controls; 15.2% vs. 2.0% (x2 = 46.08, p<0.001). There was similarly high and significant prevalence of bipolar affective disorder in first degree relatives of patients with epilepsy compared with normal control; 14.5% vs. 2.1 % (X2 = 31.2, p<0.001). Conclusion: The biological links already noted by earlier studies between bipolar disorders and epilepsy seem to be strengthened by this findings of familial predisposition. This may be a prelude io other similar or more advanced studies to establish definite genetic link between these two important disorders

The Mental Health System in North-Eastern Nigeria: A WHO-AIMS Generated Assessment of the State of Mental Health in a Sub-Saharan African Region.

Background: Mental health care is considered an important subsystem of health care and, consists of all the activities whose primary purpose is to promote, restore, or maintain mental health. Regional disparities in socio-economic indices may lead to failures in implementing policies based on data generated at the national scale. The definition of a detailed description of the mental health system of the north-eastern region is critical to the understanding of the essential weaknesses in its health care delivery process, allowing for the formulation of appropriate intervention plan to strengthen the system. The aims and objectives include provision of a comprehensive analysis of the mental health system in north-eastern Nigeria and baseline data for regional mental health Gap action Plan (mhGAP) policy formulation and implementation.Methods: The mental health system of the north-eastern region was defined using a WHO tool, World Health Organization Assessment instrument for mental health system WHO-AIMS version 2.2,.The instrument which is composed of six domains that collects comprehensive information on the mental health system of a country or region.Results: The regional expenditure towards mental health is 1% of the total health budget, with 76% of this directed at curative measures in the region’s mental hospital. There is a ratio of 0.52 beds per 10000 people with 61% of available hospital beds being located within the mental hospital in Maiduguri. In terms of human resources, the region has 13 Psychiatrists (0.069 per 100,000) Vs (1.44 per 100,000) on the national scale and 2 Psychologists (0.01 per 100,000) Vs (0.11 per 100,000) on the national level.Discussion: The health systems in most of the developing countries including Nigeria are weak. However the situation in the north east is relatively worse as demonstrated across all the WHO-AIMS domains. There is about a hundred fold difference in the available mental health personnel in the Egyptian mental health service compared to the north-east of Nigeria.Conclusion: This report has clearly defined what must be done to achieve a particular target of improvement in mental health service at the regional level. A separate policy implications document of the findings of this study including a SWOT analysis may be possible to generate. This may be relevant to spur the political will necessary for the improvement of the situation as suggested by this study

Prevalence and Factors Responsible for Stigmatization of the Mentally Ill among Student Nurses in North-Eastern Nigeria

Introduction: There is poor knowledge about mental illness, which contributes to stigmatization. The extent of the problem have been studied across cultures and found to be common(Gureje et al, 2005; Adewuya, 2007; Aghukwa, 2010) The impact of the stigma associated with mental illness is negative and pervasive; affecting patients, their family members, health care givers and the wider community. There is a need to determine the extent and factors associated with the tendency to stigmatize the mentally ill among future health care providers such as student nurses, who are potential community health educators.Aim: The study aimed to find the prevalence and the factors associated with stigma due to psychosis among student nursesMethods: It was a comparative cross sectional study of the prevalence of, and factors associated with mental illness stigma among student nurses using the Osgood semantic differential and World Psychiatric Association questionnaire on psychiatric stigma.Results: A total of 126 subjects participated in the study. The average age of the respondents was 23.7 years (SD=3.7), with an intra centre average of 23.0 and 24.6 for the Maiduguri and Damaturu centres respectively. The study demonstrated that in both study groups there was a general negative attitude (78-88.1% thought the mentally ill patients were dangerous; 78-88.5% would not marry people who had mental illness) and relatively good knowledge (29- 36% believed in a magical/ spiritual aetiology of mental disorders) about mental illness.Conclusion: Overall generally high levels of psychiatric stigma exist amongst the students' nurses, with very few socio demographic variables being associated with the levels of stigm