Psychometric validity of the distress thermometer and problem check list in ART-na\uefve HIV infected patients in Northern Nigeria

Background: HIV diagnosis comes with a lot of worry and distress. Ability to objectively estimate this distress by non-psychiatrist will enhance early detection of psychological distress for intervention. Objectives: To investigate the validity of the Distress Thermometer (DT) and its problem checklist in achieving early detection of mental distress among ART-na\uefve HIV infected patient. Materials and Methods: A total of 90 ART-na\uefve HIV infected patients completed the DT and its problem check list, Hospital Anxiety Depression Scale (HADS), Oslo Social Support Scale and the 14-item Resilience Scale. Results: The DT was positively correlated with all the measures of distress and reversely correlated with all the positive wellness in this study. The correlations were only significant for the negative measures of psychological wellness. The internal consistency of the DT\u2019s problem list overall and sub-categories were within acceptable range (i.e. \u3b1 > 0.50). The Receiver Operating Characteristic (ROC) curves and Area Under the Curves (AUC) analysis were significant and found the DT and Problem List to respectively differentiate between cases of distress, anxiety and depression. The DT\u2019s cut-off was >5.0 with AUC range (0.754 \u2013 0.709); sensitivity range (81.0% \u2013 70.4%); specificity range (68.3% \u2013 65.2%) for distress, anxiety and depression as determined by HADS. And the Problem List cut-off was >6.0 with AUC range (0.854 \u2013 0.821); sensitivity range (90.5% - 85.7%); specificity range (68.3% - 65.2%) for distress, anxiety and depression as measured by HADS. Conclusion: The DT and Problem List were found to be valid measures of distress in ART-na\uefve HIV infected patients

Electroencephalographic findings in patients referred for electroencephalogram in a University Teaching Hospital in Northern Nigeria

Background: Electroencephalogram (EEG) is a valuable investigation for the assessment of patients with seizures and some other neuropsychiatric disorders. The literature is scanty of reports describing its application and usefulness in Nigerian patients. In this study we analyzed the EEG records of a series of patients who were referred with various provisional diagnoses. Materials and Methods: EEG records of the entire 200 consecutive cases referred from various clinics within and outside a tertiary hospital in Northern Nigeria during a 1 year period were analyzed. Information on biodemographic data, clinical description of symptoms and provisional diagnosis made by referring physicians and the EEG diagnosis were obtained from the records. Results: Most of the attendees were aged between 10 years and 29 years (59.5%) and mostly males (63.5%). About 80% of the attendees had received a provisional diagnosis of seizure disorder (generalized and partial). The EEG diagnosis of seizure disorder accounted for 75%, normal EEG record accounted for 21% and organic brain disorder accounted for 4% of all EEG diagnosis. Generalized seizure disorder was the commonest seizure type by EEG diagnosis (50%). There was a significant association between the provisional diagnosis and EEG diagnosis (P < 0.05). Conclusion: Most of the patients referred for the EEG had their reports consistent with clinical suspicion. EEG was found to be a useful tool in the evaluation of seizures and organic brain disorder in our study

Post-stroke depression: Prevalence, associated factors and impact on quality of life among outpatients in a Nigerian hospital

Objectives: To investigate the prevalence of post-stroke depression (PSD), its associated factors and impact on quality of life (QoL) among outpatients in a Nigerian hospital. Methods: This cross-sectional study was carried out among 140 adults made up of 70 stroke survivors and matched controls with stable hypertension. Participants were administered questionnaires to profile their socio-demographic and clinical characteristics. Subsequently, they were assessed with the modified mini-mental state examination (MMSE), modified Rankin Scale (mRS), schedule for clinical assessment in neuropsychiatry (SCAN) and World Health Organization Quality of Life-BREF (WHOQoL-BREF). Results: The mean ages (± s.d.) of stroke survivors and controls were 57.43 (± 9.67) years and 57.33 (± 9.33) years, respectively. Majority of stroke survivors (n = 55 [78.6%]) had infarctive stroke, and 37 (52.9%) had right hemispheric lesion. Sixteen (22.9%) stroke survivors had PSD, with moderate to severe depression (F32.1) being the most prevalent, while none of the controls was clinically depressed. PSD correlated positively with monthly health bill above 10 000 naira ($61), significant post-stroke disability and poorer scores on all QoL domains (p < 0.05). Conclusion: Depression was 20-fold prevalent in stroke survivors compared to controls with stable hypertension, and sevenfold the life-time prevalence reported among adult general population in Nigeria. Furthermore, increased health care bills per month, significant post-stroke disability and poorer QoL indicated survivors more likely to have depression. Findings in this study support the need to pay closer attention to psychosocial needs of stroke survivors to improve well-being. Future longitudinal study on psychosocial burden of stroke is warranted