Stress and training satisfaction among resident doctors in Nigeria: Any justification for a change in training policy?

Background: There are pointers in existing literature to the stressful nature of residency program, thereby placing training physicians at increased risk of psychological distress. Objectives: The study identified perceived stress, its sources, training satisfaction, and the associated sociodemographic characteristics among resident doctors. Materials and Methods: A total of 405 self-administered questionnaires were given to all attendees of the National Postgraduate Medical College Revision Course. The questionnaires sought information on sociodemographic variables, sources of stress, and training satisfaction. Only 20 questionnaires were not returned. Data were collated and analyzed. Results: A majority of the respondents were male (69.1%), mostly between 31 and 35 years of age. Most (80%) of the respondents were married while 51.4% had over 4 dependents. All the respondents reported a significant level of stress, and different sources of stress were identified. Only 12 (3.1%) of the respondents were satisfied with the quality of training being received in their institutions. Conclusion: Our study found residency training to be stressful for doctors and often compounded by identifiable variables as shown in this study. Such stressful experience can, in turn, have negative impacts on their physical along with mental well-being and the patient care. Thus, there is a need for relevant stakeholders to review the structure of residency program with the view of addressing “modifiable risks” of stress among would-be specialists

Estimating the weighted prevalence of anxiety disorders in breast cancer patients using a Two-stage approach

Background: A two-stage survey is useful when the actual diagnostic interview is time-consuming and expensive to administer on the general population. Objective: To compare Schedule for Clinical Assessment in Neuropsychiatry (SCAN) with Hospital Anxiety and Depression Scale (HADS) in the determination of the prevalence of anxiety disorder in patients with breast cancer. Methods: A cross-sectional study of 200 female patients diagnosed with breast cancer attending the Oncology Out-Patients Clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria was done. The instruments used for the survey included a socio-demographic questionnaire, the HADS and the SCAN. Results: The mean age of the subjects was 49.6 ± 11.2 years. Majority of the subjects (76.5%) were married. Using HADS with a threshold score of ≥ 8, 53 (26.5%) met the criteria for probable anxiety disorders (herein called ‘cases’). Of the 68 patients (all 53 ‘cases’ plus 15 randomly selected 10% of the non-cases) interviewed with the SCAN instrument, only 38 met the criteria for diagnosis of anxiety disorder. Conclusions: The prevalence of anxiety disorders can be determined with greater precision using the two-stage design approach. Diagnostic tools like SCAN should therefore be incorporated in the assessment protocols for patients with breast cancer and other illnesses

Support the frontliners – good initiatives during the COVID-19 pandemic for healthcare workers across the world: is this what we really need?

Healthcare workers have faced an unprecedented workload in overstretched health facilities during the COVID-19 pandemic, and we describe various initiatives to support them. Psychological, financial and peer support, accommodation and meal services, proper personal protective equipment, applause and gratitude in the community, spiritual and religious life, child care and volunteering were identified. The potential effects of the COVID-19 pandemic – permanent stress, burnout and other mental health problems among healthcare professionals – can be expected to grow. Continued monitoring is essential to bolster resilience among healthcare workers and prevent the possible consequences for their mental health.info:eu-repo/semantics/publishe

Management of psychiatric conditions and delirium during the COVID-19 pandemic across continents: lessons learned and recommendations

Background: With the uncertainties of COVID-19, people infected with coronavirus present with diverse psychiatric presentations. Some institutions have had to manage their patients with existing protocols, others have had to create them. In this article we aimed to report the challenges and good practices in the management of psychiatric conditions and delirium coexisting with COVID-19 across continents. Methods: Early Career Psychiatrists (ECPs) from across five continents were approached to share their experiences on the management of psychiatric conditions in patients with COVID-19 during the current pandemic. Results: We collected information about the experiences from sixteen countries. Commonalities were similar psychiatric presentations and poor preparedness across countries. Differences were varying adjustments made in the management of psychiatric conditions coexisting with COVID-19 and different innovations. Good practices which can be adopted by other countries are novel approaches such as telepsychiatry, proactive consultation-liaison units and enhanced community services targeted at circumventing challenges faced when providing mental health services. Conclusions: These findings highlight the need for global preparedness in the mental health sector during outbreaks of infectious diseases, and the need for concerted efforts targeted at global and locally sensitive adaptation of existing protocols and the development of new guidelines for the management of psychiatric conditions for the present pandemic and subsequent occurrences

How to overcome barriers to publication in low- and middle-income countries:Recommendations from early career psychiatrists and researchers from around the world

There is an increasing movement toward international collaboration and global discussion in mental health. If provided with the right opportunities, early career psychiatrists (ECPs) and researchers in mental health can contribute meaningfully to this discussion. However, they often experience multiple barriers when attempting to add their voices via academic publications. We represent a diverse group of ECPs and researchers from all six World Health Organization regions. In this piece, we discuss these barriers, grounded in our first-hand experiences, and put forth a series of recommendations. The most potentially beneficial and immediate way forward is ensuring a much-needed mentorship and support, particularly for low- and middle-income countries. In this regard, international organizations, especially those with a particular focus on education, such as the Section on Education in Psychiatry of the World Psychiatric Association, can play a pivotal role