Burden of care amongst caregivers who are first degree relatives of patients with schizophrenia

Introduction: Caring for a mentally ill family member is a challenging task. Caregivers who are first-degree relatives (FDR) are at a higher risk of experiencing the negative consequences of caregiving. This study was aimed at determining burden of care and its correlates in caregivers who are first-degree relatives of patients with schizophrenia. Methods: A dyad of 255 patients and caregivers was recruited. A socio-demographic questionnaire was administered to both. The GHQ-12 was used to screen for psychiatric morbidity in the FDRs. Caregiver's burden was assessed with the Zarit Burden Interview. Patients' illness severity and level of functioning were assessed using the Brief Psychiatric Rating Scale and the Global Assessment of Functioning scales respectively. Results: The mean ± SD age of caregivers and patients were 45.1 ±12.3 and 36.7 ±13.4 years respectively. About 49% of caregivers experienced high burden of care. Older caregiver's age (r = 0.179; p < 0.004) and greater illness severity (r = 0.332; p < 0.0001) in the patient had weak to moderate positive correlation with burden of care. Caregiver's burden also increased with poorer functioning of the patient (r = -0.467 p < 0.0001). Independent predictors of caregiver burden were low level of education of the caregiver (OR 2.45; 95% CI 1.27-4.73), psychiatric morbidity in the caregiver (OR 6.74; 95% CI 2.51-18.15) and poor patient functioning (OR 2.81; 95% CI 1.27-6.18). Conclusion: Caregivers who are first-degree relatives of patients with schizophrenia experience varying degrees of burden of care during caregiving. Routine screening and early psychological intervention would help to ameliorate these negative consequences of caregiving

Depression among patients with diabetes mellitus in a Nigerian teaching hospital

Objectives. Depression is associated with diabetes mellitus and affects treatment goals negatively. We aimed to determine the prevalence of depression and identify its socio-demographic or clinical correlates among patients with diabetes mellitus attending an out-patient clinic in Nigeria. Methods. Two hundred consecutively recruited diabetes patients (index group) were compared with a similar number of apparently healthy controls in a cross-sectional survey. In both groups, in addition to obtaining socio-demographic details, depression was diagnosed using the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN), while the Beck Depression Inventory (BDI) was used to assess depression symptom severity. Results. Sixty (30%) diabetes patients met a SCAN diagnosis for clinical depression, compared with 19 (9.5%) in the control group. Having a smaller income and more children were significantly correlated with higher depression symptoms on the BDI. Conclusion. Depression is highly co-morbid with diabetes mellitus. The care of individuals with diabetes mellitus should include the screening and possible treatment for depression in order to achieve and sustain treatment goals

Stigmatising attitudes towards persons with mental illness: a survey of medical students and interns from Southern Nigeria

Stigmatising attitudes towards persons with mental illness are commonly reported among health professionals. Familiarity with mental illness has been reported to improve these attitudes. Very few studies have compared future medical doctors’ attitudes toward types of mental illness, substance use disorders and physical illness. A cross-sectional survey of 5th and 6th year medical students as well as recently graduated medical doctors was conducted in April 2011. The 12-item level of contact report  and the Attitude towards Mental Illness Questionnaire were administered. Participants endorsed stigmatising attitudes towards mental illness; with attitudes more adverse for schizophrenia compared to depression. Stigmatising attitudes were similarly endorsed for substance use disorders. Paradoxically, attitudes towards HIV/AIDS were positive and similar to diabetes mellitus. Increasing familiarity with mental illness was weakly associated with better attitudes towards depression and schizophrenia. Stigmatising attitudes towards depression and schizophrenia are common among future doctors. Efforts to combat stigma are urgently needed and should be promoted among medical students and recent medical graduates