Scholarly works in Psychiatry
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Item Exploring differences between adolescents and adults with perinatal depression-data from the expanding care for perinatal women with depression trial in Nigeria(2019-10) Oladeji, B. D.; Bello, T.; Kola, L.; Araya, R.; Zelkowitz, P.; Gureje, O.Background: Depression is common among women in the perinatal period. Although pregnancy and motherhood among adolescents are global public health issues, little is known about how adolescents differ from adults in the occurrence and correlates of perinatal depression. Methods: Data were derived from a cluster randomized controlled trial of psychosocial interventions for perinatal depression in primary maternal care in Nigeria (the Expanding Care for Perinatal Women with Depression trial). Adolescents and adult participants recruited during pregnancy and followed up till 6-month postpartum were compared: proportions with depression [screening positive to depression on the Edinburgh Postnatal Depression Scale (score ≥ 12) and meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria using the short form of the Composite International Diagnostic Interview]; adjustment and attitude to pregnancy and motherhood (using the Maternal Adjustment and Maternal Attitudes scale); and parenting skills (measured on Infant–Toddler version of the Home Inventory for Measurement of the Environment). Infant and fetal growth were assessed by measures of weight and head circumference at birth and upper mid-upper arm circumference (MUAC) at 6 months. Results: Of 8,580 adults screened, 6.9% had major depression compared with 17.7% of 772 screened adolescents (p < 0.001). Adolescents had significantly poorer adjustment and attitudes to pregnancy, lower mean fetal gestational age at birth, and a smaller mean baby’s birth weight. At 6-month postpartum, there were no significant differences in the rates of remission from depression between adolescent and adult women (Edinburgh Postnatal Depression Scale score <6). Adolescent mothers continued to have poorer maternal attitudes and parenting skills indicated by significantly lower scores on the Infant–Toddler version of the Home Inventory for Measurement of the Environment responsivity and involvement subscales. Infants of adolescent mothers had a higher rate of undernutrition (defined as MUAC < 12.5 cm) compared with those of adult mothers: 14.8 and 6.3%, respectively (p = 0.008), with the mean MUAC remaining significantly lower for infants of adolescent mothers after adjusting for their lower birth weight (p = 0.04). Conclusion: Perinatal depression is more common and is associated with poorer maternal attitudes and parenting skills in adolescents compared with those in adults. Evidence from this exploratory study suggests that in improving outcomes in infants of adolescent mothers with perinatal depression, depression treatment may need to be supplemented with specific approaches to improve parenting skills.Item Prevalence and correlates of major depressive disorder (MDD) among adolescent patients with epilepsy attending a Nigerian neuropsychiatric hospital(Elsevier, 2016) Fela-Thomas, A.; Akinhanmi, A.; Esan, O. B.Background: A high prevalence of mood disorders exists in patients with epilepsy. In most cases, this is not detected and, consequently, not treated. This study aimed to determine the prevalence and correlates of major depressive disorder (MDD) among adolescents with epilepsy attending a child and adolescent clinic in Nigeria. Methods: We recruited 156 participants consecutively for the study. Adherence was assessed using the 8 item Morisky Medication Adherence Questionnaire, while the K-SADS was used to assess the presence of major depressive disorder. Seizure control was evaluated by the frequency of seizures within a year. Results: Major depressive disorder (DSM-IV criteria) was diagnosed in 28.2% of the participants. The age of participants (p = 0.013), seizure control (p = 0.03), medication adherence (p = 0.045), frequency of seizures in the preceding 4 weeks (p b 0.001), and duration of illness (p b 0.001) were all significantly associated with the presence of MDD. Participants with seizures occurring more than once weekly in the preceding 4 weeks were 16 times more likely to have a MDD compared with those with no seizures in the preceding 4 weeks (p b 0.001, 95% C.I. [4.13, 65.43]), while participants with a duration of illness morethan10yearsweremorethanfourtimeslikelytohaveMDDcomparedwiththosewithanillnessdu ration of 5–10 years (p b 0.01, 95% C.I. [0.07, 0.70]). Conclusion: The prevalence of MDD among patients with epilepsy was high. Poor seizure control, poor medication adherence, and long duration of illness were associated with the presence of MDD among such patients. Intervention should focus on ensuring good seizure control and optimal adherence in order to mitigate the impact of MDD in patients with epilepsyItem Gender and rural-urban differences in the nutritional status of in-school adolescents in south-western Nigeria(Cambridge University Press, 2010) Omigbodun, O.O.; Adediran, K.I.; Akinyemi, J.O.; Omigbodun, A.O.; Adedokun, B.O.; Esan, O.B.This study assessed gender and rural/urban differences in height and weight, and the prevalence of stunting, underweight and overweight of school-going adolescents in south-west Nigeria, using 2007 WHO reference values for comparison. The influence of sexual maturity and the socio demographic correlates of growth performance were also examined. In this cross-sectional study, 924 male (51.4%) and 875 female (48.6%) students (1799 in total) aged 10–19 years from eighteen schools in Ibadan (five rural, nine urban public and four urban private) were interviewed and examined. Although males were significantly taller than females (p<0.05) stunting was more pronounced for males, who were 7.5 cm shorter than the 2007 WHO reference, compared with females who were 3.5 cm shorter. Body mass index (BMI) for girls was also greater than for boys (p<0.05) Rural adolescents had lower heights and BMIs compared with those in urban areas. The mean height of male adolescents in rural schools fell below 2 SDs of the 2007 WHO reference between 14 and 17 years, while heights of males and females in private schools were similar to the median 2007 WHO standard. Low height-for-age was observed in 282 adolescents (15.7%), which, after multivariate analysis, was significantly associated with school type, gender, number of mother’s children and puberty onset. Adolescents in rural schools were much more likely to be stunted than those in urban private schools (AOR 13.1; 95% CI 5.2–33.2) and males were three times more likely to be stunted compared with females (AOR 3.3; 95% CI 2.4–1.4). Low BMI-for-age was observed in 240 adolescents (18.9%), with correlates similar to stunting. Adolescents at the pre-puberty stage were twice as likely to have low BMI-for-age (OR 2.0; 95% CI 1.6–2.5) than those with signs of puberty. There were 2.3% overweight adolescents, who were significantly more likely to be female, in private school and post-pubertal. Innovative interventions for Nigerian adolescents, especially rural inhabitants and males, are needed to reduce the prevalence of stunting and underweightItem Prevalence and correlates of suicidal behaviour among adolescents in southwest Nigeria(Nigerian Medical Association, 2008) Omigbodun, O.; Dogra, N.; Esan, O.B.; Adedokun, B.Background: Despite being recognized by the World Health Organization as a significant social and health concern, information on suicidal behaviours in Nigerian adolescents is unknown. Aims: To establish the prevalence and associated psychosocial correlates of suicidal ideation and attempts in Nigerian youth. Methods: Stratified sampling was used to identify youth aged 10–17 years who completed the Nigeria version of the Global School Health Questionnaire (GSHQ) and the Diagnostic Predictive Scale (DPS) for youths (suicidal behaviour questions) in a classroom setting. Results: A total of 1429 youth completed the instruments. Over 20% reported suicidal ideation and approximately 12% reported that they had attempted suicide in the last year. Adolescents living in urban areas, from polygamous or disrupted families, had higher rates of suicidal behaviour. Multiple psychosocial factors such as sexual abuse, physical attack and involvement in physical fights were significant predictors of suicidal behaviour. Conclusion: Factors associated with suicidal ideation and behaviours are similar to those found in other studies but the rates of both suicidal ideation and attempts are towards the upper limit of rates for youth. This study suggests that there is an urgent need for Nigerian policymakers and health providers to review and address this issue.