Effectiveness of a training programme on the knowledge and perception of Attention-Deficit Hyperactivity Disorder among primary school teachers in Kano, Nigeria

This study assessed the effect of Attention-Deficit Hyperactivity Disorder (ADHD) training on teachers’ knowledge and perception of the condition in Kano, Nigeria. It was a controlled trial of 200 primary schoolteachers from two Local Government Areas (LGAs). One LGA was randomly assigned to the intervention group and the other to a waitlist control (100 teachers per group). The intervention group received two training sessions on ADHD one week apart. The training was based on the Mental Health Gap Action Programme – Intervention Guide (mhGAP-IG). Participants completed the ADHD Knowledge Questionnaire, ADHD Attitude Scale, and Knowledge of Behavioral Intervention Questionnaire at baseline and one-week post-intervention. The participants ranged from 17 to 58 years (Mean = 34.1 years; SD = 8.7), comprising 112 females and 85 males. The intervention and control groups were broadly similar at baseline. Controlling for baseline scores and other differences (age, gender, duration of teaching experience, and if schools employed staff dedicated to helping children with mental health difficulties such as ADHD), the intervention group had significantly higher scores on Knowledge of ADHD and Knowledge of Behavioral Management of the condition, with effect sizes of 0.7 and 0.3, respectively. This intervention led to statistically significant improvements in the teachers’ knowledge of ADHD and behavioral intervention for ADHD. This provides further evidence of the feasibility and effectiveness of specific ADHD-training interventions for primary school teachers in Nigeria

Diagnostic and management challenges of pre-pubertal bipolar disorder in an eight-year old Nigerian child: A case report and review of literature

An eight-year old boy presented with a 1-week history of poor sleep, over activity and claiming that parents wanted to use him for rituals. He was admitted unto the male psychiatry ward and while on admission he was overactive and disruptive, irritable, grandiose and dis-inhibited with loss of age-appropriate social grace. To our knowledge, this is the youngest age that bipolar disorder has been reported in Nigeria. The diagnostic and management challenges were highlighted

A controlled trial of Cognitive Behavioural Therapy-based strategies for insomnia among in-school adolescents in southern Nigeria

Background: Sleep difficulties are highly prevalent among adolescents, and are associated with significant impairments. The effectiveness and acceptability of Cognitive Behavioural Therapy-based (CBT-based) treatment for insomnia in adolescents is established for High Income Countries, but unknown for African settings. Thus, the aim of this study was to assess the effect of CBT-based intervention among in-school adolescents with sleep difficulties in Southern Nigeria. Methods: This was a pilot controlled trial involving 50 adolescents with highest ranked scores on the Insomnia Severity Index (ISI) recruited from four schools (two government and two privately owned). Balloting was used to assign two schools (public and private) with 25 participants to the intervention group, and the other two schools (public and private) with 25 participants as waiting-list controls. The two groups were dyad-matched for baseline ISI scores, gender, and type of school to reduce baseline differences. The treatment group received weekly group-based manualised CBT-based intervention over 5 weeks. Primary outcome was ISI score at 6th week. Secondary outcomes were sleep onset latency (SOL), Total sleep duration (TSD), depressive symptoms, sleep hygiene, and knowledge about sleep. Results: Participants were aged 13–17 years (M = 14.9, SD = 1.16) and consisted of 18 males and 32 females. Controlling for baseline scores, the intervention group showed significantly lower post-intervention insomnia scores compared with the control group {F (1, 34) = 1.10, p = 0.0001, (ηp2 = 0.59}, shorter SOL {F (1, 33) = 1.41, p = 0.0001, ηp2 = 0.39}, longer TSD {F (1, 33) = 1.03, p = 0.0001, ηp2 = 0.47}, lower depressive symptoms {F (1, 31) = 1.32, p = 0.002 (ηp2 = 0.34}, higher knowledge of sleep {F (1, 34) = 1.02, p = 0.001, ηp2 = 0.36}, but no significant change in sleep hygiene {F (1, 32) = 1.08, p = 0.08, ηp2 = 0.15}. All participants in the intervention group rated the programme as good or excellent. Conclusion: This pilot CBT-based intervention for adolescents with insomnia was feasible, well received and showed promising efficacy in this setting. Larger controlled trials are recommended to establish the generalisability of these findings in this region

Effect of a brief supportive and educational intervention on the psychological well-being of mothers with babies in neonatal wards of a Tertiary Hospital in Ibadan, Nigeria

OBJECTIVE: To assess the effect of a supportive educational intervention on the psychological wellbeing of mothers whose babies were admitted to Neonatal Care Unit (NCU) in Nigeria. METHODS: Controlled trial involving 41 mothers whose babies were consecutively admitted into two NCUs (21 in the intervention group and 19 controls). The intervention group received two group-based sessions which included psychological coping strategies, and familiarity with NCU environment, equipment, personnel and procedures. The control group received usual care. Outcome measures were depressive symptoms (Edinburg Postnatal Depression Scale—EPDS), stress-related to NCU (Parental Stressor Scale: Neonatal Intensive Care Unit—PSS: NICU) and post-traumatic symptoms (Impact Event Scale-Revised—IES-R). RESULTS: Difference-in-Differences (DiD) analysis showed a difference of −4.70 in PSS: NICU score in favour of the intervention group which was statistically significant [F(3, 75) = 9.47, p < 0.0001, R2 = 0.28]. The differences in EPDS (0.91) and IES-R (2.55) were not statistically significant [F(3, 75) = 10.10, p = 0.74] and [F(3, 75) = 10.13, p = 0.73], respectively. All the mothers in the treatment group expressed satisfaction with the intervention. CONCLUSION: This brief group-based supportive educational intervention for mothers with babies in NCU was feasible, acceptable and helpful in reducing stress related to NCU. Larger controlled trials are recommended to establish the generalizability of these findings in this region

Identifying social labels for mental illness in a Nigerian university: the overt problem of public stigmatisation of persons affected

Introduction: Labelling remains one of the forms of public stigma experienced by persons with mental illness and this has its attendant consequences not only for the individual sufferer but also for the family members/care-givers and the society as a whole. In a bid to avoid labelling and other forms of public stigma there is a tendency to avoid reporting, denying signs and symptoms of mental illness, seeking treatment as appropriate, or avoiding places where stigmatization is often experienced such as schools or social gatherings.Methods: The study was a Focus Group Discussion that took place in the University of Ibadan. Participants were undergraduate students who were volunteering as prospective mental health peer counsellors.Result: Seventeen volunteers participated in the FGDs. The FGPs volunteered a total of 20 names/terms that are used to refer to or describe people experiencing mental health problems, some of which include “Wéré!”, “scoin-scoin”, “Aro”, “imbalance”, “breakdown”, “kolo”, “nkan ti tasi l'opolo”, “mood switch”, ”issues”, “brain touch”, “psycho”, “madness”, “Prof”, “iwé!”, “Alase”, “West West G” (West West Ground), “Yaba Left” and “unbalanced”.Discussion: These terms are obviously derogatory and stigmatizing and may themselves have negative impact on the mental health of the affected person. Most of the names given by the participants are quite similar to those mentioned by the participants in similar studies to explore the role of stigma in relation to treatment avoidance. Stigmatization not only lowers the self-esteem of those affected, it may lead to mood disorders, poor treatment adherence and poor academic functioning.Conclusion: Public stigma towards persons with mental health issues is still a social issue. Considering the widespread existence of public stigma towards persons with mental illness and its attendant consequences, continued efforts through established effective methods should be made to address this issue, so as to ensure that individuals experiencing mental health issues will always feel free to seek help and function better in all ramifications of daily life.Support: A partial bursary was received from the John D. and Catherine T. McArthur Foundation, University of Ibadan, for this study

Psychiatric morbidity among pregnant and non pregnant women in Ibadan, Nigeria

A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.Impact statement What is already known on this subject? Psychiatric morbidity has immense effects on a woman’s quality of life, social functioning, obstetric outcome, and economic productivity. What do the results of this study add? Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression. What are the implications of these findings for clinical practice and/or further research? Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability