Browsing by Author "Oladeji, B."

Now showing 1 - 20 of 22

A community-based intervention for improving utilization of medical services by rape survivors in refugee camps in Zambia
(2019) Oladeji, O.; Owoaje, E.; Oladeji, B.; Fatiregun, A.
Background: Rape is the most common form of violence in conflict and refugee situations but because of the associated stigma few cases are reported. This study assessed the outcome of an intervention targeted at women groups on the utilization of medical services by rape survivors in refugee camps in Zambia. Methods: A prospective quasi-experimental community-based intervention study was carried out in two refugee camps allocated into intervention and comparison areas. The intervention was participatory education sessions for women groups. Data was collected using the clinic records and the main outcome was the number of rape survivors who utilized and completed medical services provided at the camp clinics. Univariate, bivariate and multivariate analyses were carried out with level of significance set at 5%. Results: The proportion of the rape survivors who accessed medical care within 72 hours increased significantly from 41.2% to 84.8% in the intervention area but from 31.1% to 38.9% in the comparison area, (p=0.005). Those who completed their medical treatment and the follow-up visits increased significantly from 42.8% to 94.8% in intervention area but reduced from 38.5% to 21.4% in the comparison area, (p=0.002). Being resident in the intervention area predicted the utilization of medical services, [OR: 3.15; 95%CI: 1.955-5.681], p=0.002. Conclusion: Community-based intervention using participatory women’s group discussion had a significant impact on increasing the utilization of medical services by rape survivors and should be considered for scaling up as a key intervention for increasing utilization of medical services for rape survivors especially in refugee situations.
A survey of traditional and faith healers providing mental health care in three sub-Saharan African countries
(Springer Science + Business Media, 2019) Esan, O.B.; Appiah-Poku, J.; Othieno, C.; Kola, L.; Harris, B.; Nortje, G.; Makanjuola, V.; Oladeji, B.; Price, L.; Seedat, S.; Gureje, O.
Background: Traditional and faith healers constitute an important group of complementary and alternative mental health service providers (CAPs) in sub-Sahara Africa. Governments in the region commonly express a desire to integrate them into the public health system. The aim of the study was to describe the profile, practices and distribution of traditional and faith healers in three sub-Saharan African countries in great need for major improvements in their mental health systems namely Ghana, Kenya and Nigeria. Materials and methods: A mapping exercise of CAPs who provide mental health care was conducted in selected catchment areas in the three countries through a combination of desk review of existing registers, engagement activities with community leaders and a snowballing technique. Information was collected on the type of practice, the methods of diagnosis and the forms of treatment using a specially designed proforma. Results: We identified 205 CAPs in Ghana, 406 in Kenya and 82 in Nigeria. Most (> 70%) of the CAPs treat both physical and mental illnesses. CAPs receive training through long years of apprenticeship. They use a combination of herbs, various forms of divination and rituals in the treatment of mental disorders. The use of physical restraints by CAPs to manage patients was relatively uncommon in Kenya (4%) compared to Nigeria (63.4%) and Ghana (21%). CAPs often have between 2- to 10-fold capacity for patient admission compared to conventional mental health facilities. The profile of CAPs in Kenya stands out from those of Ghana and Nigeria in many respects. Conclusion: CAPs are an important group of providers of mental health care in sub-Saharan Africa, but attempts to integrate them into the public health system must address the common use of harmful treatment practices.
Association between depression and hypertension in the Ibadan Study of Ageing. African
(2020) Ajayi, S.O.; Oladeji, B.; Abiona, T.; Gureje, O.
Introduction: The elderly population is growing all over the world with attendant increase in occurrence of comorbid conditions. Using data from a longitudinal study of community-dwelling elderly persons in Nigeria, we explored the prevalence and corelates of hypertension and depression as well as the factors associated with the comorbidity of these two conditions. Methods: The Ibadan Study of Ageing, a longitudinal community-based cohort study conducted between 2003 and 2009 on the profile and determinants of successful ageing. A multistage cluster random sampling was used to select a cohort of elderly participants from across eight contiguous Yoruba speaking states in Nigeria- Ekiti, Kogi, Kwara, Lagos, Ogun, Ondo, Osun, and Oyo. Participants (non-institutionalized elderly, aged 65 years or over) were assessed at 4 time points: baseline(2003/2004) and annually from 2007 (wave 1), 2008 (wave 2 and 2009 (wave 3). Data was collected in face-to-face interviews; depression was assessed using the World Mental Health initiative version of the Composite International Diagnostic Interview (CIDI), social engagement was assessed using an adapted World Health Organization Disability Assessment Schedule WHODAS) and functional disability using activities of daily living (ADL) and instrumental activities of daily living (IADL). Hypertension was defined according to the Joint National Committee-7(JNC7) recommendations as systolic blood pressure of 140 mmHg and above, diastolic blood pressure of 90mmHg. This current study is based on cross-sectional data from the wave 1(2007) assessment. Results: Of the 1597 participants, 58% were females and 42% were 70 years and older. The mean age was 74.2 years (SD ±7.8). Nine hundred and ninety-eight (62.5%) participants had hypertension while 177 (10.6%) met the criteria for major depression while comorbid depression and hypertension was present in 122 (7.1%). The comorbidity of hypertension and depression was significantly associated with gender (higher in women) (p=0.001), insomnia (p=0.001), lack of family participation (p=0.001), lack of community participation (p=0.002), and experiencing a negative life event in the past year (p=0.003). In a multivariate analysis, lack of participation in family activities was associated with an increased risk of co-morbidity between hypertension and depression (OR 4.51, p=0.000, CI 2.14-9.50). Conclusions: These findings suggest that the comorbidity of depression and hypertension could potentially be minimized by modifying social risk factors such as keeping the elderly involved in family and community life participation by promoting their involvement in recreational and volunteer activities as well as social gatherings.
Childhood stress: neurobiology and association with adult physical and mental disorders
(2011) Oladeji, B.
Many people experience significant stressful or traumatic events in childhood. These events often leave a scar that may manifest in the form of adult psychopathology and chronic physical conditions. The neurobiological basis of the link between these childhood experiences and adult health problems is increasingly being studied and understood. The advantage of this understanding is that even if the exposure to traumatic and stressful events in childhood cannot be entirely prevented, the consequences of such exposure may be ameliorated by the institution of early intervention to persons at greatest risk.
Clinical correlates of schizophrenia: a study at the University College Hospital, Ibadan
(2002) Morakinyo, J. J.; Oladeji, B.; Odejide, A. O.
Comparative case studies in integrated care implementation from across the globe: a quest for action
(Springer, 2019) Stadnick, N. A.; Sadler, E.; Sandall, J.; Turienzo, C. F.; Bennett, I. M.; Borkan, J.; Oladeji, B.; Gureje, O.; Aarons, G. A.; Sklar, M.
Background: Integrated care is the coordination of general and behavioral health and is a highly promising and practical approach to improving healthcare delivery and patient outcomes. While there is growing interest and investment in integrated care implementation internationally, there are no formal guidelines for integrated care implementation applicable to diverse healthcare systems. Furthermore, there is a complex interplay of factors at multiple levels of influence that are necessary for successful implementation of integrated care in health systems. methods: Guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework (Aarons et al., 2011), a multiple case study design was used to address two research objectives: 1) To highlight current integrated care implementation efforts through seven international case studies that target a range of healthcare systems, patient populations and implementation strategies and outcomes, and 2) To synthesize the shared and unique challenges and successes across studies using the EPIS framework. Results: The seven reported case studies represent integrated care implementation efforts from five countries and continents (United States, United Kingdom, Vietnam, Israel, and Nigeria), target a range of clinical populations and care settings, and span all phases of the EPIS framework. Qualitative synthesis of these case studies illuminated common outer context, inner context, bridging and innovation factors that were key drivers of implementation. Conclusions: We propose an agenda that outlines priority goals and related strategies to advance integrated care implementation research. These goals relate to: 1) the role of funding at multiple levels of implementation, 2) meaningful collaboration with stakeholders across phases of implementation and 3) clear communication to stakeholders about integrated care implementation.
Depression in adult Nigerians: results from the Nigerian Survey of Mental Health and Well-being
(Cambridge University Press & Assessment, 2010) Gureje, O.; Uwakwe, R.; Oladeji, B.; Makanjuola, V.O.; Esan, O.B.
Background: Community-based studies of the rates and profile of depression among Africans are still sparse. Methods: As part of the World Mental Health Surveys initiative, a clustered multi-stage sampling of households in 21 of Nigeria's 36 states (representing 57% of the national population) was implemented to select adults aged 18 years and over(N=6752)for face-to-face interviews using the Composite International Diagnostic Interview (CIDI 3.0). Diagnosis of major depressive episode (MDE) was based on the criteria of the Diagnostic and Statistical Manual, 4th edition. Results: Lifetime and 12 monthestimatesofMDEwere3.1%(standarderror0.3) and1.1% (s.e.0.1), receptively. Increasing age was associated with higher estimates of positive responses to stem (screen)questions for depression and of lifetime disorders among stem-positive respondents. The mean age of onset was about 29.2 years. The median (inter quantile range, IQR) duration of an episode among lifetime cases was 1.0 (2.0–2.4) year and the median (IQR) number of lifetime episodes was 1.5 (2.0–2.8). MDE was highly comorbid with anxiety disorders, musculoskeletal conditions, chronic pain and ulcer. The odds ratio of lifetime suicide attempt among persons with lifetime MDEwas11.6(95%confidenceinterval,3.9–34.9).Over25%of12-monthcaseswererated as severely disabled in the performance of usual roles. Only 16.9%(i.e. 5.0) of 12-monthcases had received any treatment. Limitations: All data were based on self-reports. Conclusion: MDE, defined according to DSM-IV, is a risk factor for mental and physical comorbidity as well as disability in Nigerians. Age-related telescoping or denial may partly explain the low rates in this young population
Determinants of transition across the spectrum of alcohol use and misuse in Nigeria
(Elsevier Inc, 2013) Esan, O.B.; Makanjuola, V.; Oladeji, B.; Gureje, O.
Many studies have examined the risk factors associated with alcohol use disorders. No information is available from developing countries about the factors that may determine the transitions across different levels of use and misuse. Alcohol use and its misuse were assessed in a cohort of 2143 Nigerians using Version 3.0 of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI). This generated six levels of alcohol use and related disorders. Using age of onset variables created for the purpose, analysis was done to determine rates of and risk factor for transition between the levels. Lifetime prevalence estimates were 57.8% for alcohol use, 27.6% for regular use, 2.9% for abuse, and 0.3% for dependence. Whereas 47.8% transited to regular use from lifetime ever use, only 10.5% transited to abuse from regular use and 9.5% from abuse to dependence. Male sex, age 18e49 years and being never married predicted onset of alcohol use. Transition to regular use was predicted only by male sex while transition to abuse was predicted by male sex and age 35e49 years. Factors associated with recovery from abuse were female sex and a student status. Higher rates of transition occurred in the stages preceding the onset of alcohol use disorders. Sex and age were the main determinants of transition, with male gender and middle age being risk factors for transition to problematic use of alcohol.
Determinants of transition across the spectrum of alcohol use and misuse in Nigeria
(Elsevier, 2013) Esan, O.; Makanjuola, V.; Oladeji, B.; Gureje, O.
Many studies have examined the risk factors associated with alcohol use disorders. No information is available from developing countries about the factors that may determine the transitions across different levels of use and misuse. Alcohol use and its misuse were assessed in a cohort of 2143 Nigerians using Version 3.0 of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI). This generated six levels of alcohol use and related disorders. Using age of onset variables created for the purpose, analysis was done to determine rates of and risk factor for transition between the levels. Lifetime prevalence estimates were 57.8% for alcohol use, 27.6% for regular use, 2.9% for abuse, and 0.3% for dependence. Whereas 47.8% transited to regular use from lifetime ever use, only 10.5% transited to abuse from regular use and 9.5% from abuse to dependence. Male sex, age 18e49 years and being never married predicted onset of alcohol use. Transition to regular use was predicted only by male sex while transition to abuse was predicted by male sex and age 35e49 years. Factors associated with recovery from abuse were female sex and a student status. Higher rates of transition occurred in the stages preceding the onset of alcohol use disorders. Sex and age were the main determinants of transition, with male gender and middle age being risk factors for transition to problematic use of alcohol.
Effect of gender on the utilization of maternal and child health services among pastoralist caregivers in Somali region of Ethiopia
(2021) Oladeji, O.; Oladeji, B.; Chamla, D.; Robins, A.; Belalahy, V.
Ethiopia has made great effort in recent years to improve maternal and child health outcomes, however the uptake of services by women in the pastoralist communities of the country is still very low. This study was a cross-sectional study aimed to identify the effect of gender on the utilization of health services among pastoralists women. The study was conducted in Somali Region of Ethiopia between February and March 2020. A mix of qualitative and quantitative methods was used, and study population were married caregivers aged 15years and above. Bivariate analysis was done using t test and chi-square to test association among variables and p value was set at significant level of 5%. Husbands were reported as the main influence of the respondents’ decision about almost all the key households’ activities including health care seeking and financial decision making. Almost all caregivers (93.6%) who used the health facility took permission from their husbands and the test of association shows significant relationship between level of education and permission from respondents’ husbands which decreases with increasing level of education, p<0.05) but not affected by age. The care givers visited the health facilities because of their children more than themselves (58 per cent compared to 49.5 per cent for themselves) due to fear of being attended to by male health work. The study demonstrated the negative effect of gender inequities on health care seeking behaviours with women having limited control over family resources and decision-making over their health or that of their children.
Effectiveness of traditional healers in treating mental disorders - a systematic review
(Elsevier, 2016) Nortje, G.; Oladeji, B.; Gureje, O.; Seedat, S.
Traditional healers form a major part of the mental health workforce worldwide. Despite this, little systematic examination has been done of their effectiveness in treating mental illness or alleviating psychological distress. In this Review, we aim to fill this gap, with a focus on quantitative outcomes. We searched four databases and reference lists for papers that explicitly measured the effectiveness of traditional healers on mental illness and psychological distress. Eligible papers were assessed for quality, and outcomes and other details were extracted with the use of a standardized template. 32 eligible papers from 20 countries were included. The published literature on this topic is heterogeneous and studies are generally of poor quality, although some findings emerge more consistently. Some evidence suggests that traditional healers can provide an effective psychosocial intervention. Their interventions might help to relieve distress and improve mild symptoms in common mental disorders such as depression and anxiety. However, little evidence exists to suggest that they change the course of severe mental illnesses such as bipolar and psychotic disorders. Nevertheless, qualitative changes that are captured poorly by conventional rating scales might be as important as the quantitative changes reviewed here. We conclude by outlining the challenges involved in assessing the effectiveness of traditional healers.
Evaluation of the iCARE Nigeria pilot intervention using social media and peer navigation to promote HIV testing and linkage to care among high-risk young men: a nonrandomized controlled trial
(2022-02) Garofalo, R.; Adetunji, A.; Kuhns, L. M.; Omigbodun, O.; Johnson, A. K.; Kuti, K. M.; Awolude, O. A.; Berzins, B.; Janulis, P.; Okonkwor, O.; Oladeji, B.; Muldoon, A. L.; Amoo, O. P.; Atunde, H.; Kapogiannis, B.; Taiwo, B. O.
IMPORTANCE Nigeria has the fourth-largest HIV epidemic globally, yet high levels of social stigma inhibit HIV testing among Nigerian youths and young men who have sex with men (MSM). OBJECTIVE To report pilot data from iCARE Nigeria (Intensive Combination Approach to Roll Back the Epidemic in Nigerian Adolescents), a combination intervention using social media and peer navigation to promote HIV testing and linkage to care among high-risk youths and young men (hereinafter referred to as young men), including predominantly young MSM. DESIGN, SETTING, AND PARTICIPANTS This nonrandomized controlled study assessed an organizational and community-level 12-month, preintervention-postintervention pilot trial of a combination intervention designed to increase HIV testing uptake, increase the rate of identified seropositive cases, and improve linkage to care among young men, including MSM, using social media outreach and peer navigation. Data were collected from June 1, 2019, to May 30, 2020. Participants were young men aged 15 to 24 years in the city of Ibadan, Nigeria, and surrounding areas. Frequencies and percentages were examined, and a Fisher exact test was used to evaluate outcomes compared with historical surveillance data. Linkage to care was defined as 2 clinic visits, including HIV confirmation, within 2 months of a positive rapid test result. INTERVENTION Four peer navigators conducted social media outreach promoting sexual health and guiding individuals to HIV counseling and rapid testing in clinical, community, or home-based settings. MAIN OUTCOMES AND MEASURES Primary outcomes included the number of young men tested for HIV at university-based iCARE catchment clinics or by iCARE peer navigators in the community, the postintervention HIV seroprevalence of these groups, and linkage to care of participants diagnosed with HIV infection. RESULTS A total of 339 participants underwent testing for HIV (mean [SD] age, 21.7 [1.9] years), with 283 (83.5%) referred through social media. The main referral sources for social media were WhatsApp (124 [43.8%]), Facebook (101 [35.7%]), and Grindr (57 [20.1%]). Regarding testing location, participants chose home (134 [39.5%]), community-based (202 [59.6%]), or clinic (3 [0.9%]) settings. Eighty-six participants reported no prior HIV testing. Thirty-six participants (10.6%) were confirmed as HIV seropositive; among those, 18 (50.0%) reported negative test results within the past year, and 31 (86.1%) were linked to care. In two 6-month follow-up periods, the intervention increased HIV testing by 42%and 31%, respectively, and seroprevalence increased compared with historical trends with odds ratios of 3.37 (95%CI, 1.43-8.02; P = .002) and 2.74 (95%CI, 1.10-7.11; P = .02), respectively. CONCLUSIONS AND RELEVANCE These findings suggest that use of iCARE Nigeria was associated with increased HIV testing and linkage to care in a high-risk, difficult-to-reach population, making it a promising combination intervention for young MSM.
Explanatory model of psychosis: impact on perception of self-stigma by patients in three sub-saharan African cities
(Springer Science + Business Media, 2016) Makanjuola, V.; Esan, O.B.; Oladeji, B.; Kola, L.; Appiah-Poku, J.; Harris, B.; Othieno, C.; Price, L.; Seedat, S.; Gureje, O.
Mental disorders are cross-culturally ubiquitous [1]. Psychosis is, by far, the more easily recognisable form of mental disorder by the lay public and traditional healers [2]. While the experience of psychosis is universal, interpretation of the experience, notions of causation, treatment, preferred source of care, and the consequences and perceptions of associated stigma vary from one culture to another. We used a mixed-methods approach consisting of in-depth interviews with key informants to explore respondents’ explanatory models of the causation of psychosis as well as questionnaire assessment of the level of internalized (or self) stigma. The conduct of the interviews was guided by the specifications of the McGill Illness Narrative Interview (MINI) [32], a semi-structured interview guide which, among other things, elicits lay illness narratives. A purposively selected sample of patients who were receiving treatment from traditional healers was interviewed. The transcribed interviews were read several times by the first author and subjected to thematic analysis. Supernatural and biopsychosocial explanatory models of the causation of psychosis were both endorsed by our respondents. Despite this, the majority of the respondents with severe forms of self-stigma held supernatural attributions. However, we also found that some respondents with low self-stigma embraced a supernatural model while some respondents with high self-stigma proffered a biopsychosocial explanation. Our findings suggest that individualising interventions to minimize self-stigma may be a better approach than programs that generically promote biopsychosocial models or discourage supernatural models.
Human Immunodeficiency Virus Type 1 and tuberculosis co-infection in multinational resource limited settings: increased neurological dysfunction
(Oxford Academic, 2019) Robertson, K.; Oladeji, B.; Jiang, H.; Kumwenda, J.; Supparatpinyo, K.; Campbell, T.; Hakim, J.; Tripathy, S.; Hosseinipour, M.; Marra, C. M.; Kumarasamy, N.; Evans, S.; Vecchio, A.; La Rosa, A.; Santos, B.; Silva, M. T.; Montano, S.; Kanyama, C.; Firnhaber, C.; Price, R.; Marcus, C.; Berzins, B.; Masih, R.; Lalloo, U.; Sanne, I.; Yosief, S.; Walawander, A.; Nair, A.; Sacktor, N.; Hall, C.; AIDS Clinical Trials Group
Background. AIDS Clinical Trial Group 5199 compared neurological and neuropsychological test performance of human immunodeficiency virus type 1 (HIV-1)–infected participants in resource-limited settings treated with 3 World Health Organization–recommended antiretroviral (ART) regimens. We investigated the impact of tuberculosis (TB) on neurological and neuropsychological outcomes. Methods. Standardized neurological and neuropsychological examinations were administered every 24 weeks. Generalized estimating equation models assessed the association between TB and neurological/neuropsychological performance. Results. Characteristics of the 860 participants at baseline were as follows: 53% female, 49% African; median age, 34 years; CD4 count, 173 cells/μL; and plasma HIV-1 RNA, 5.0 log copies/mL. At baseline, there were 36 cases of pulmonary, 9 cases of extrapulmonary, and 1 case of central nervous system (CNS) TB. Over the 192 weeks of follow-up, there were 55 observations of pulmonary TB in 52 persons, 26 observations of extrapulmonary TB in 25 persons, and 3 observations of CNS TB in 2 persons. Prevalence of TB decreased with ART initiation and follow-up. Those with TB coinfection had significantly poorer performance on grooved pegboard (P < .001) and finger tapping nondominant hand (P < .01). TB was associated with diffuse CNS disease (P < .05). Furthermore, those with TB had 9.27 times (P < .001) higher odds of reporting decreased quality of life, and had 8.02 times (P = .0005) higher odds of loss of productivity. Conclusions. TB coinfection was associated with poorer neuropsychological functioning, particularly the fine motor skills, and had a substantial impact on functional ability and quality of life.
Intermittent explosive disorder subtypes in the general population: association with comorbidity, impairment and suicidality
(Cambridge University Press, 2020) Scott, K. M.; de Vries, Y. A.; Aguilar-Gaxiola, S.; Al-Hamzawi, A.; Alonso, J.; Bromet, E. J.; Bunting, B.; Caldas-de-Almeida, J. M.; Cía, A.; Florescu, S.; Gureje, O.; Hu, C. Y.; Karam, E. G.; Karam, A.; Kawakami, N.; Kessler, R. C.; Lee, S.; McGrath, J.; Oladeji, B.; Posada-Villa, J.; Stein, D. J.; Zarkov, Z.; de Jonge, P.
Aims. Intermittent explosive disorder (IED) is characterised by impulsive anger attacks that vary greatly across individuals in severity and consequence. Understanding IED subtypes has been limited by lack of large, general population datasets including assessment of IED. Using the 17-country World Mental Health surveys dataset, this study examined whether behavioural subtypes of IED are associated with differing patterns of comorbidity, suicidality and functional impairment. Methods. IED was assessed using the Composite International Diagnostic Interview in the World Mental Health surveys (n = 45 266). Five behavioural subtypes were created based on type of anger attack. Logistic regression assessed association of these subtypes with lifetime comorbidity, lifetime suicidality and 12-month functional impairment. Results. The lifetime prevalence of IED in all countries was 0.8% (S.E.: 0.0). The two subtypes involving anger attacks that harmed people (‘hurt people only’ and ‘destroy property and hurt people’), collectively comprising 73% of those with IED, were characterised by high rates of externalising comorbid disorders. The remaining three subtypes involving anger attacks that destroyed property only, destroyed property and threatened people, and threatened people only, were characterized by higher rates of internalising than externalising comorbid disorders. Suicidal behaviour did not vary across the five behavioural subtypes but was higher among those with (v. those without) comorbid disorders, and among those who perpetrated more violent assaults. Conclusions. The most common IED behavioural subtypes in these general population samples are associated with high rates of externalising disorders. This contrasts with the findings from clinical studies of IED, which observe a preponderance of internalising disorder comorbidity. This disparity in findings across population and clinical studies, together with the marked heterogeneity that characterizes the diagnostic entity of IED, suggests that it is a disorder that requires much greater research.
Mental health
(Cambridge University Press, 2013) Gureje, O.; Oladeji, B.
Mental Health: morbidity and impact
(San Diego Elsevier Academic Press, 2008) Gureje, O.; Oladeji, B.
Parental psychopathology and the risk of suicidal behavior in their offspring: results from the world mental health surveys
(Macmillan Publishers Limited, 2011) Gureje, O.; Oladeji, B.; Hwang, I.; Chiu, W. T.; Kessler, R. C.; Sampson, N. A.; Alonso, J.; Andrade, L. H.; Beautrais, A.; Borges, G.; Bromet, E.; Bruffaerts, R.; de Girolamo, G.; de Graaf, R.; Gal, G.; He, Y.; Hu, C.; Iwata, N.; Karam, E. G.; Kovess-Masféty, V.; Matschinger, H.; Moldovan, M. V.; Posada-Villa, J.; Sagar, R.; Scocco, P.; Seedat, S.; Tomov, T.; Nock, M. K.
Previous research suggests that parental psychopathology predicts suicidal behavior among offspring; however, the more fine-grained associations between specific parental disorders and distinct stages of the pathway to suicide are not well understood. We set out to test the hypothesis that parental disorders associated with negative mood would predict offspring suicide ideation, whereas disorders characterized by impulsive aggression (for example, antisocial personality) and anxiety/agitation (for example, panic disorder) would predict which offspring act on their suicide ideation and make a suicide attempt. Data were collected during face-to-face interviews conducted on nationally representative samples (N= 55 299; age 18þ) from 21 countries around the world. We tested the associations between a range of parental disorders and the onset and persistence over time (that is, time since most recent episode controlling for age of onset and time since onset) of subsequent suicidal behavior (suicide ideation, plans and attempts) among offspring. Analyses tested bivariate and multivariate associations between each parental disorder and distinct forms of suicidal behavior. Results revealed that each parental disorder examined increased the risk of suicide ideation among offspring, parental generalized anxiety and depression emerged as the only predictors of the onset and persistence (respectively) of suicide plans among offspring with ideation, whereas parental antisocial personality and anxiety disorders emerged as the only predictors of the onset and persistence of suicide attempts among ideators. A dose-response relation between parental disorders and respondent risk of suicide ideation and attempt was also found. Parental death by suicide was a particularly strong predictor of persistence of suicide attempts among offspring. These associations remained significant after controlling for comorbidity of parental disorders and for the presence of mental disorders among offspring. These findings should inform future explorations of the mechanisms of intergenerational transmission of suicidal behavior.
Prevalence and correlates of sexual dysfunction among patients with mental disorders in a tertiary hospital in Southwest Nigeria
(2021) Adesola, A. O.; Oladeji, B.
Background: Sexual dysfunction is more common among patients with mental disorders compared to the general population. Despite this high occurrence, information regarding sexual dysfunction as well as their correlates in patients receiving care for mental disorders in developing countries is still sparse. Aim: To determine the prevalence and correlates of sexual dysfunction among patients with mental disorders receiving care in a tertiary hospital in Southwest Nigeria. Setting: This study was performed at the psychiatric outpatient clinic at the University College Hospital, Ibadan, Southwest Nigeria. Methods: A cross-sectional study was conducted on a convenience sample of 238 adults aged 18–60 years. Socio-demographic and clinical information was obtained from all recruited patients. Sexual dysfunction was assessed using the International Index of Erectile Function questionnaire for men and the Female Sexual Function Index questionnaire for women. Questionnaires for measuring depression, medication adherence and autonomic medication side effects were also administered. Associations between sexual dysfunction and socio-demographic and clinical factors were explored. Results: The prevalence rates of sexual dysfunction among male and female participants were 84.7% and 95.7%, respectively. In the multivariate analysis, employment status and autonomic side effects of psychotropic medications significantly predicted male sexual dysfunction, while religion and employment status were predictors of female sexual dysfunction. Conclusion: Sexual dysfunction is very common among patients with mental disorders, with higher rates in female participants. There is a need for clinicians to consider routine screening for sexual dysfunction in psychiatric outpatients with a view of providing psychosocial interventions to improve patient’s quality of life.
Psychiatric disorders and adherence to antiretroviral therapy among a population of HIV-infected adults in Nigeria
(Sage publications, 2016) Adejumo, O.; Oladeji, B.; Akpa, O.; Malee, K.; Baiyewu, O.; Ogunniyi, A.; Evans, S.; Berzins, B.; Taiwo, B.
Psychiatric disorders are common among HIV patients in Nigeria. Adherence is necessary to optimize the outcome of antiretroviral therapy. In this study, we aimed to identify associations between antiretroviral adherence measured by 1-week and 1-month self-reported missed doses, and psychiatric illness in a cohort previously assessed for psychiatric disorders using the Composite International Diagnostic instrument (CIDI). The study participants comprised 151 adults with major depression, anxiety or suicidal symptoms, and 302 matched-control participants. Two controls were randomly selected for each case within the same gender and education stratum. We compared participants with psychiatric disorders (WPDs) and without psychiatric disorders (NPDs) on selected demographic and clinical variables, in addition to adherence. Participants with 1 or more missed doses in the preceding month had twice the odds of having a major depressive episode as those with no missed doses during this period (OR 2.22, 95% CI 1.03, 4.79). This association remained significant after adjusting for selected risk factors. There was no statistically significant difference between WPD and NPD groups on either 1-week or 1-month adherence, or on age, marital status, occupational class, HIV viral load at enrollment or current CD4. Among Nigerian adults with HIV, suboptimal antiretroviral adherence is associated with, and could be a Corresponding author: Olurotimi Adejumo, Department of Psychiatry, University College Hospital, PMB 5116, Ibadan, Nigeria, Phone: +2348033778540, +13122167417, radejumo@yahoo.com. HHS Public Access Author manuscript Int J STD AIDS. Author manuscript; available in PMC 2016 October 01. Published in final edited form as: Int J STD AIDS. 2016 October ; 27(11): 938–949. doi:10.1177/0956462415600582. Author Manuscript Author Manuscript Author Manuscript Author Manuscript pointer to depression. Routine self-report adherence assessments may have potential utility for identifying individuals at risk among this population.