Browsing by Author "Gureje, O."

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Community study of knowledge of and attitude to mental illness in Nigeria
(Taylor and Francis Group, 2005) Gureje, O.; Lasebikan, V. O.; Ephraim-Oluwanuga, O.; Olley, B. O.; Kola, L.
Background: The improvement of community tolerance of people with Mental illness is important for their integration. Little is known about the knowledge of and attitude to mental illness in sub-Saharan Africa. Aims: To determine the knowledge and attitudes of a representative community sample in Nigeria. Method: A multistage, clustered sample of household respondents was studied in three states in the Yoruba-speaking parts of Nigeria (representing 22% of the national population). A total of 2040 individuals participated (response rate 74.2%). Results: Poor knowledge of causation was common. Negative views of mental illness were wide spread, with as many as 96.5% (s.d. =0.5) believing that people with mental illness are dangerous because of their violent behaviour. Most would not tolerate even basic social contacts with a mentally ill person: 82.7% (s.e.=1.3) would be afraid to have a conversation with a mentally ill person and only16.9% (s.e.=0.9) would consider marrying one. Socio-demographic predictors of both poor knowledge and intolerant attitude were generally very few. Conclusions: There is widespread stigmatisation of mental illness in the Nigerian community. Negative attitudes to mental illness may be fuelled by notions of causation that suggest that affected people are in some way responsible for their illness, and by fear.
Depression and disability: comparisons with common physical conditions in the Ibadan study of aging
(Elsevier Ltd., 2008-11) Gureje, O.; Ademola, A.; Olley, B. O.
Objectives: To compare the effects of depression and chronic physical conditions on disability in elderly persons. Setting: Yoruba-speaking areas of Nigeria. Design: Interviews. Participants: Community-dwelling persons aged 65 and older. Method: Face-to-face interviews were conducted with a representative sample of community-dwelling persons aged 65 and older (N= 2,152) in the Yoruba-speaking areas of Nigeria (representing ~22% of the national population). Major depressive disorder (MDD) was assessed using the World Health Organization Composite International Diagnostic Interview. Chronic pain and medical disorders were assessed using self-report. Disorder-specific disability was evaluated using the Sheehan Disability Scale (SDS). Results: MDD was highly comorbid with each of the medical conditions (odds ratio range 1.3–2.0). A higher proportion of persons with MDD (47.2%) were rated severely disabled globally than those with arthritis (20.6%), chronic spinal pain (24.2%), or high blood pressure (25.0%). Subjects with MDD were also more likely to be severely disabled in three of the four domains of the SDS. In pair-wise comparisons, persons with MDD had significantly higher levels of disability than those with any of the disorders, with differences in mean scores ranging between -3.74 and -27.50. Conclusion: To reduce the public health burden of depression, its prevention and treatment require more clinical and research attention than currently given by developing countries.
A descriptive epidemiology of substance use and substance use disorders in Nigeria during the early 21st century
(Elsevier Ltd., 2007) Gureje, O.; Degenhardt, L.; Olley, B; Uwakwe, R.; Udofia, O; Wakil, A; Adeyemi, O; Bohnert, K. M.; Anthony, J. C.
Background: Several studies have examined the use of psychoactive substances among selected groups in Nigeria. Here, we extend the description to include the features of substance dependence. Method: A stratified multi-stage random sampling of households was used to select respondents in 21 of Nigeria's 36 states (representing 57% of the national population). In-person interviews with 6752 adults were conducted using the World Health Organization Composite International Diagnostic Interview, Version 3. Lifetime history and recent (past year) use, as well as features of dependence on, alcohol, tobacco, cannabis, sedatives, stimulants, and other drugs were assessed. Results: Alcohol was the most commonly used substance, with 56% (95% confidence interval, CI = 54, 58%) ever users and 14% (95% CI = 13, 15%) recent (past year) users, Roughly 3% were recent smokers (3%, 95% CI = 2.6, 4.2%). Next most common were sedatives. 4% (95% CI = 2.3, 4.5%), and cannabis smokers, 0.4% (95% CI =0.1, 0.6%). Males were more likely than females to be users of every drug group investigated, with male preponderance being particularly marked for cannabis. Prevalence of both alcohol and tobacco use was highest among middle aged adults. Moslems were much less likely to use alcohol than persons of other faiths, but no such association was found for tobacco, non-prescription drug use, or illegal drug use. Features of abuse and dependence were more common at the population level for alcohol; but among users, these features were just as likely to be experienced by alcohol users as they were by other drug users. Conclusion: Alcohol is the most commonly used psychoactive drug' in Nigeria. Features associated with drug dependence and abuse arc less prevalent but may require attention by public health authorities.
Do beliefs about causation influence attitudes to mental illness?
(Elsevier Ltd., 2006-06) Gureje, O.; Olley, O.; Ephraim-Oluwanuga, O.; Kola, L.
Studies indicate that stigmatizing attitudes to mental illness are rampant in the community worldwide. It is unclear whether views about the causation of mental disorders identify persons with more negative attitudes. Using data collected as part of a community study of knowledge of and attitudes to mental illness in Nigeria, we examined the relationships between views about causation and attitudes. Persons holding exclusively biopsychosocial views of causation were not different from those holding exclusively religious-magical views in regard to socio-demographic attributes, and the two groups were not very dissimilar when general knowledge of the nature of mental illness was compared. However, religious-magical views of causation were more associated with negative and stigmatizing attitudes to the mentally ill. Findings demonstrate the challenge of developing and delivering an educational program to change public attitudes to mental illness.
Do Young Schizophrenics with Recent onset of Illness Show Evidence of Hypofrontality?
(1994) Gureje, O.; Olley, O.; Acha, R. A.; Osuntokun, B. O.
Young schizophrenic patients (n = 43), manic controls (n = 32), both groups diagnosed according to the Research Diagnostic Criteria and on remission from acute illness, and 53 normal subjects were given a battery of neuropsychologic tests selected to assess different functional areas in the brain. Compared with normal controls, patient groups showed evidence of impaired functioning of many cortical areas but with the schizophrenics having the worst performance. In addition, schizophrenic patients performed poorly in tests designed to assess frontotemporal cortical functioning. This pattern of deficits differentiated schizophrenics from both manic and normal subjects. The results suggest that widespread cognitive deficits are a feature of both schizophrenia and mania but that frontal lobe dysfunction may be more specific to the former. It would also appear that these impairments are not artefacts of age, chronicity or of institutionalization, and are present even in schizophrenic patients who may have an illness with putative better outcome than those studied in previous reports.
Hubris, humanity and the humongous lessons of the brain
(2015) Gureje, O.
Profile comorbidity and impact of insomnia in the Ibadan
(Elsevier Ltd., 2009) Gureje, O.; Kola, L.; Ademola, A.; Olley, B. O.
Background: Little is known about factors that determine the QoL of elderly persons living in developing societies undergoing rapid social changes. Method: A representative sample of elderly Nigerians, aged 65 years and over (n= 2152), was assessed for QoL using the World Health Organization Quality of Life instrument (WHOQoLBref). Other than sociodemographic factors, respondents were also evaluated for major depressive disorder, physical conditions as well as for social network, support and engagement. Using linear regression modeling, these factors were explored for their ability to predict the physical, psychological, social and environmental domains of QoL. Results:Economic status was the most consistent predictor of the four domains of QoL, with the coefficients ranging between 1.0 and 1.68 (p < 0.001 in every instance). Among health variables, functional disability (range: 7.07 – 19.86) and self-rated overall health (range: 7.89 – 18. 42) were the most salient. Participation in community activities (range 7.74 – 17.48) was the most consistent social predictor. As a group, social factors, especially those relating to social support and participation, were the strongest determinants of QoL. Conclusion: Even though health factors are important, social factors, in particular those relating to the quality of social support and participation, are the most important predictors of QoL.
Profile comorbidity and impact of insomnia in the Ibadan
(Elsevier Ltd., 2009) Gureje, O.; Kola, L.; Ademola, A; Olley, B. O.
Objective: To provide information on the profile, comorbidity and impact of insomnia among an understudied group of elderly Africans. Method: Using the WHO Composite International Diagnostic Interview (CIDI), the 12-month prevalence of three forms of insomnia was assessed in face-to-face interviews conducted with a regionally-representative sample of elderly Nigerians, aged 65 years and over (n=2152). The association of insomnia with quality of life, rated with the WHO Quality of Life instrument, was analyzed controlling for comorbid chronic pain, chronic medical conditions and DSM-IV major depressive disorder. Results: At least one insomnia problem was reported by 30.72%. Insomnia was more frequent among females, persons aged 70 years and over, and those who were unmarried. Insomnia was comorbid with major depressive disorder (OR = 3.9, 95% CI 2.5 – 6.1), chronic pain (OR = 4.3, 95% CI 3.2 – 6.1; particularly arthritis and spinal pain), and chronic medical conditions (OR = 2.1, 95% CI 1.8 – 2.5, particularly heart disease, high blood pressure or asthma). Persons with insomnia were more likely to report having had a fall in the previous year (OR = 1.4, 95% CI 1.0 –1.8) and, among those with fall, injury was more commonly reported by those with insomnia. Every form of insomnia was associated with decrement in quality of life. After controlling for comorbid mental and physical conditions, the β coefficients ranged between −17.9 and −20.0. Conclusion: Insomnia was highly comorbid with chronic physical conditions and with depression. These comorbid conditions partly but do not entirely account for the considerable decrement in quality of life associated with insomnia.