Post-traumatic stress disorder among the staff of a mental health hospital: Prevalence and risk factors

Background: Mental health service providers are frequently exposed to stress and violence in the line of duty. There is a dearth of data concerning the psychological sequelae of the frequent exposure to stress and violence, especially among those who work in resource-limited countries such as Botswana. Aim: To determine the prevalence and predictors of post-traumatic stress disorder (PTSD) among mental health workers in a tertiary mental health institute in Botswana. Setting: The study was conducted in Sbrana Psychiatric Hospital, which is the only referral psychiatric hospital in Botswana. Methods: The study used a descriptive cross-sectional design. A total of 201 mental health workers completed a researcher-designed psycho-socio-demographic questionnaire, which included one neuroticism item of the Big Five Inventory, and a PTSD Checklist-Civilian Version (PCL-C), which was used to assess symptoms of PTSD. Results: Majority of the study participants were general nurses (n = 121, 60.5%) and females (n = 122, 60.7%). Thirty-seven (18.4%) of the participants met the criteria for PTSD. Exposure to violence in the past 12 months (AOR = 3.26; 95% CI: 1.49–7.16) and high neuroticism score (AOR = 2.72; 95% CI: 1.19–6.24) were significantly associated with the diagnosis of PTSD among the participants. Conclusion: Post-traumatic stress disorder could result from stressful events encountered in the course of managing patients in mental health institutes and departments. Pre-placement personality evaluation of health workers to be assigned to work in psychiatric units and post-incident trauma counselling of those exposed to violence may be beneficial in reducing the occurrence of PTSD in mental hospital health care workers

Entrepreneurial characteristics of principal partners of architectural firms in Lagos, Nigeria

Very few studies have investigated entrepreneurial characteristics of principal architects, who venture out on their own, rather than practice under established organizations. The research was done to determine and quantify the entrepreneurial characteristics of the principal partners of architectural firms in Lagos, Nigeria. A cross-sectional survey of 92 principal partners of architectural firms in Lagos State, carried out in March 2018 and Questionnaires were used in obtaining the data. Results from the analyzed data showed that there is a correlation between the entrepreneurial characteristics of principal partner and the performance of their firms in that their leadership skill and prowess have a direct influence on their firms. This, however, does not necessarily result in a better outcome in all measures of performance investigated. This is because the two entrepreneurial characteristics only affect the ability of the firms to expand. The recommendation, therefore, is that architecture schools should include leadership training and capacity building programs to produce effective contemporary architects who consequently will lead a successful firm, thus bringing repute to the field of architecture. This research can also be implemented on a large scale in other fields for comparative analysis

Early-onset psychosis in an adolescent with DiGeorge syndrome: A case report

DiGeorge syndrome (DGS) was first described in 1829 by Dr Angelo DiGeorge. DGS is a cluster of symptoms because of a defect in the development of the pharyngeal pouch. Evidence from cytogenetic studies has linked the pathogenesis of DGS with a deletion of a gene located in chromosome 22-band 22q11. In most affected individuals, the deletion is de novo; however, inheritance has been reported in 10% – 25% of patients. DGS commonly presents with a classical triad of conotruncal cardiac anomalies, hypoplastic thymus and hypocalcaemia. DGS may be of focus to a psychiatrist as it is associated with cognitive deficits, high rates of schizophrenia and anxiety disorders. Patients may also present to mental health care workers with learning disabilities, developmental delay and behavioural disorders such as attention-deficit or hyperactivity disorder. Mental health workers therefore play an invaluable role in the diagnosis and timely treatment of the disorder. In a resource-limited area such as Botswana, with scarce mental health professionals, paediatricians and neurologists, DGS may be frequently misdiagnosed with consequent inappropriate interventions that may increase morbidity. Herein, we present a case to raise awareness and demonstrate one of the varied ways the syndrome may present. The multifaceted nature of DGS presentation underscores the need for a multidisciplinary approach to treatment

Physical violence against health staff by mentally ill patients at a psychiatric hospital in Botswana

Abstract Background Workplace violence is worrisome in the mental health sector. Little is understood about it in sub-Saharan Africa. Consequently, we decided to investigate the prevalence, related factors, and the available sources of support for the victims of workplace violence in a mental referral hospital in Botswana. Methods We conducted a cross-sectional retrospective survey of 201 mental health staff (MHS) of Sbrana Psychiatric Hospital, Botswana. We used a self-administered questionnaire to obtain information on socio-demographics and various aspects of work-related violence and available source of supports. We also used Andrew and Withey Job Satisfaction Questionnaire to assess the workers’ level of job satisfaction. Results One hundred and seventy-nine questionnaires out of the two hundred and one returned were analyzed. One hundred and twenty-five (69.8%) of the respondents reported a lifetime experience of physical violence, while 44.1% experienced the same during the previous 12 months. Nursing services (χ2 = 29.95, p < 0.01) and long duration of service (χ2 = 29.95, p < 0.01) were associated with lifetime encounter of physical violence. Those who reported a physical assault had a higher level of job dissatisfaction than staff who never experienced violence (t = − 3.07, p = 0.02). Conclusions The rate of physical violence among mental health workers in Botswana is comparably high, and nurses are the most exposed members of staff. Protocol development and periodic training on violence prevention are hence recommended, especially for the most exposed members of staff