Socio-demographic and clinical factors associated with relapse in mental illness

Purpose: Relapse in mental illness is an issue of concern to both the patients and caregivers. This study primarily focused on determining the rate of relapse and identifying the socio-demographic and clinical factors associated with relapse. Method: A 5 year retrospective study was done involving 219 clients admitted into a mental health care facility in Nigeria. A proforma was designed to collect data on the socio-demographic and clinical variables from the client’s case notes after obtaining ethical clearance. Data was fed into SPSS version 16 and analysed using univariate and bivariate statistic. Findings: Multiple logistic regression was performed to ascertain the effect of age at onset of illness, living arrangement, family background, social class, index employment status, educational status, duration of illness and drug compliance on the likelihood of relapse in mental illness. The model was statistically significant, X2 (24) = 69.52, p < .0005, explained 36.7% (Nagelkerke R2) of the variance in relapse and correctly classified 74% of the cases. Those with duration of illness greater than five years were 3.43 times more likely to relapse than those with lesser years. Lower age of onset predicts 2.76 times more likelihood of relapse but being employed at the onset of the illness and compliance reduces the likelihood of relapse. Conclusion: This study concluded that socio-demographic and clinical factors were significantly associated with relapse. Addressing these will help achieve sustainable development goals for this population of patients. Keywords: Relapse, Readmission, Clinical factors, Socio-demographic factors, Drug complianc

Caregiver burden in families of patients with depression attending Obafemi Awolowo University teaching hospitals complex Ile-Ife Nigeria

Objective The objective of this study was to assess caregiver burden among relatives of patients on treatment for depressive disorder attending the psychiatry outpatient clinic of the Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Nigeria. Methods A cross sectional design was used. Hundred caregivers of patients with ICD-10 diagnosis of depression, on outpatient treatment for at least six months were recruited from the psychiatric outpatient clinic. Caregivers completed a semi-structured socio-demographic questionnaire, the Zarit Burden Interview and General Health Questionnaire (GHQ) 12. Descriptive statistics were used to describe socio-demographic variables; association between dependent and independent variables were assessed using Pearson’s correlation, chi squared and t test as appropriate. Results The mean ZBI score was 41.32 (S.D. = 9.82), 45% of respondents reported moderate to severe burden, spouses constituted 57% of caregivers. Age at onset of depression (t = 2.46, P = .02) number of hospitalization,(χ2 = 9.82, P = 0.001), and current active symptoms (χ2 = 36.1, P = .001) were all significantly associated with burden score. Severity of symptoms (r = 0.48, P < .01) and age at onset of illness (r = − 0.26, P < .01) both correlated significantly with burden scores, while GHQ score among caregivers also correlated significantly with burden scores (r = 0.52, P < .01). Conclusions Caregivers of depressed patients experience moderate to severe burden. Caring for the depressed need to change from a patient focused approach to a combined patient and caregiver approach

Avascular necrosis significantly impairs quality of life in sickle cell disease

Introduction: Quality of life (QoL) assessment has become an integral component of the assessment of the holistic care of patients with chronic diseases, including sickle cell disease (SCD). Objective: To evaluate the quality of life in patients with SCD managed in our centre. Patients and Methods: Eighty consecutive patients with confirmed hemoglobin SS or SC were recruited. Age and sex-matched volunteers served as controls. Ethical approval was obtained from the Institutional Review Board and all participants gave informed consent. Information on socio-demographic, quality of life and clinical variables, including the presence of complications were recorded in a modified version of the WHO Quality of Life Brief version (WHOQOL-BREF) questionnaire. Data was analyzed using Microsoft Excel and SPSS 17 computer softwares. Descriptive statistics were used to represent socio-demographic variables while the Student t-test was used to explore relationship between the variables and the quality of life domains. Results: Significantly fewer participants with SCD are married compared to their age- and sex-matched controls (P = 0.01). Similarly, participants with SCD scored significantly lower in the physical and psychological domains as well as in overall QoL and general health domains compared to controls (P = 0.001). Avascular necrosis of the femur significantly affected the overall QoL and general health of participants with SCD, respectively while the means of the QoL assessment domains were not significantly different in participants with SCD with and without complications, except in the general health domain (P < 0.001). Conclusion: Avascular necrosis of the femoral head significantly affects overall QoL in participants with SCD

Psychodermatological Disorders in Patients With Primary Psychiatric Conditions: Cross-Sectional Study

BackgroundPsychodermatological disorders (PDs) and their associations with mental health problems are one of the most frequent research themes in dermatology outpatient settings. Surprisingly, very few studies have been conducted to evaluate PDs among patients with primary psychiatric conditions. As such, the relationship between preexisting psychiatric conditions and comorbid PDs is underrepresented in the literature. ObjectiveThis study examined the prevalence and distribution of PDs among adults with primary psychiatric conditions and determined their association with underlying psychiatric diagnoses. MethodsWe conducted a cross-sectional analysis at a tertiary health care facility in southwestern Nigeria. Comorbid PDs were identified and classified using preexisting classification systems. A bivariate analysis was conducted to determine the association between PDs and underlying psychiatric conditions. The level of statistical significance was set at P<.05. ResultsThe study included 107 patients with mental health disorders, of whom 64 (59.8%) were female. The mean age of the patients was 40.73 (SD 13.08) years. A total of 75 (75/107, 70%) patients had at least one comorbid PD. The prevalence of PDs was highest in patients with affective disorders (15/20, 75%) and least in those with schizophrenia (45/66, 68%). PDs associated with delusions or hallucinations and somatoform symptoms were 9 and 13 times more frequent in patients with anxiety disorders compared to those with other psychiatric conditions (P=.01; odds ratio [OR] 9.88, 95% CI 1.67-58.34 and P=.003; OR 13.13, 95% CI 2.34-73.65), respectively. In contrast, patients with schizophrenia were significantly less likely to be diagnosed with dermatoses resulting from delusions or hallucinations (P=.002; OR 0.04, 95% CI 0.00-0.75). A weak but significant negative association was also found between psychophysiological PDs and anxiety disorders (ϕ=–0.236; P=.02). ConclusionsThis study provides important insights into the overwhelming burden of psychodermatological conditions in patients with mental health disorders and specific associations with underlying psychiatric diagnosis