Scholarly works in Psychiatry
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Item Sleep quality and cognitive impairments in remitted patients with schizophrenia in Nigeria.(Elsevier, 2021) Esan, O.B.; Ephraim-Oluwanuga, O. T.Background. – Despite the ubiquity of sleep disturbance in schizophrenia, it has generally been overlooked as a potential contributor to cognitive impairments. The main aim of this study was to find out if impaired sleep quality contributes to cognitive impairments in patients with a diagnosis of schizophrenia who are in remission. Methods. – The study was conducted at the University College Hospital, Ibadan and State Hospital, Ibadan, Nigeria. The Pittsburgh Sleep Quality Index (PSQI) and Screen for Cognitive Impairment in Psychiatry (SCIP) were applied in this cross-sectional study, to all consecutive and consenting remitted outpatients with schizophrenia (N = 130). Other instruments such as Hamilton Depression Rating Scale (HDRS), the Positive and Negative Syndrome Scale (PANSS), sociodemographic and clinical measures were also applied. Results. – There were 130 participants made up of 69 females (53.1%) and 61 males(46.9%). The mean age of the participants was 38.5 ± 9.1 years. The prevalence of poor sleep quality in remitted patients with schizophrenia was 56.9%. Sleep quality was significantly negatively correlated with Verbal Learning Test-Immediate (VLT-I) (r(128) = -.18, P = .044) and Verbal Learning Test-Delayed (VLT-D) (r(128) = -.18, P = .037). The variables that independently predicted cognitive functioning were the VLT-I, odds ratio (OR) 0.66; 95% confidence interval ((CI) 0.49-0.88) and education (OR) 0.61;(CI) 0.40- 0.92). Conclusion. – Poor subjective sleep quality measured by the PSQI is linked to cognitive impairment in remitted patients with schizophrenia. We suggest that sleep quality in remitted patients with a diagnosis of schizophrenia should receive better attention by physicians.Item Staging of schizophrenia with the use of PANSS: an international multi-center study(Oxford University Press, 2021) Fountoulakis, K.N.; Dragioti, E.; Theofilidis, A.T.; Wikilund, T.; Atmatzidis, X.; Nimatudis, I; Thys, E.; Wampers, M.; Hranov, L.; Hristova, T.; Aptalidis, D.; Milev, R.; Iftene, F.; Esan, O.B.; Oladele, O.B.; Osunbote, C.Introduction: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method. Methods: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed. Results: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. Discussion: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.Item Bipolar I disorder in remission vs. schizophrenia in remission: Is there a difference in burden?(Elsevier, 2017) Esan, O.B.; Osunbote, C.; Oladele, O.; Fakunle, S.; Ehindero, C.; Fountoulakis, K.N.Introduction: Bipolar disorder (BD) is considered to have a better outcome in comparison to schizophrenia. However, recent data dispute this notion. The current study aimed to compare the burden of patients with BD type I (BD-I) in remission with similar patients with schizophrenia (SZ) in remission. Material and Methods: Patients with schizophrenia (n=75) and BD-I (n=54) aged 18-64 years were included in the study. The diagnosis was made with the SCID-I/P. Patients were assessed for sociodemographic variables, stigma, quality of life, disability, suicidality and current symptomatology. The statistical analysis included Analysis of Covariance (ANCOVA) and chi-square test. Results: ANCOVA with age at onset as a covariate and marital status and diagnosis as grouping variables returned no significant difference. Discussion: The results of the current study suggest that when in remission, BD-I patients do not differ from patients with schizophrenia with regards to stigma, quality of life, disability level and suicidality. Also, when in remission, they do not differ regarding the severity of their psychopathology.Item Motor sequencing abnormalities are the trait marking neurological soft signs of schizophrenia(Elsevier B.V., 2015) Ojagbemi, A.; Esan, O.B.; Emsley, R.; Gureje, O.We describe the profile of NSS across the one-year course of schizophrenia in 84 Nigerian first-episode patients. They were assessed at baseline and 3 monthly for 12 months using the Neurological Evaluation Scale and the Positive and Negative Syndrome Scale (PANSS), and treated with flupenthixoldecanoate. The patternofNSStotalandsub-categoryscoresobtainedfromrepeatedmeasurementswereinvestigatedfor responders (≥50% reduction of baseline PANSS scores) and non-responders using the method of repeated measures analysis of variance. Trait-like features of NSS categories were quantified using intra class correlation coefficients (ICCs). NSS were present in 96.4% of the patients at baseline (mean 21.5±11.1). The motor-sequencing sub-category was found unrelated to changes in schizophrenia psycho pathology with treatment (positive, r=0.19, p=0.136., negative, r=0.12, p=0.350; disorganization, r=0.16, p=0.245; overall, r=0.20, p=0.112). Regardless of decrements in psychopathology, motor-sequencing scores remained relatively unchanged across the course of the disease (main effects: responders’ F=2.44, p=0.930, ‘poor responders’ F=0.27, p=0.764, entire sample F=1.87, p=0.160). ICC was “substantial” at 0.8 (95% C. I=0.6–0.9). Only the motor-sequencing NSS appear to be trait marker of schizophrenia in this sample. Other NSS seem to reflect symptomatic states of the disorder.Item Persistence in treatment for one year among patients in Nigeria with first-episode of Schizophrenia(American Psychiatric Association Publishing, 2014) Esan, O.B.Objective: The aim of this study was to examine the magnitude of poor persistence in treatment among patients with schizophrenia and to identify associated factors. Methods: All eligible patients (N5216) seen at the University College Hospital in Ibadan, Nigeria, over a five-year period were retrospectively followed up until the time of their last visit. Time to first default was examined by Kaplan-Meier survival analyses. Alog-rank test was used to compare survival times for different variables. The contribution of the variables that affected time to default was examined by Cox regression analysis. Results: Only 24% of the sample remained in treatment at the one-year follow-up. Persistence as measured by mean6SE time to all-cause treatment default was 17.8061 .44 weeks. Of several variables examined, including whether patients were taking first- or second-generation antipsychotics, none were found to predict persistence. Conclusions: Persistence in treatment of patients with a first episode of schizophrenia was low.Item Comparison of the profile of patients with acute and transient psychotic disorder and schizophrenia in a Nigerian teaching hospital(American Psychiatric Assicaition Publishing, 2013) Esan, O.B.; Fawole, O.I.Acute and transient psychotic disorders (ATPD) are different from schizophrenia; however, very little research has been done on this disorder in low-income countries, where the incidence is as high as 10 times the incidence in the more developed countries. The authors sought to identify/ characterize the sociodemographic and clinical differences between the two disorders by performing a retrospective review of the records of patients with untreated first episode of ATPD and schizophrenia seen at the University College Hospital, Ibadan, between January 1, 2006 and December 31, 2010, extracting sociodemographic and clinical data. A group of 243 patients with schizophrenia and 124 subjects with ATPD met the inclusion criteria. Patients with ATPD were more likely to present below the age of 25 years. Excitement was more common in ATPD than in schizophrenia; suspiciousness was more common in subjects with schizophrenia than ATPD. Also, anxiety and uncooperativeness were significantly more likely to occur in ATPD. Poor orientation, disturbance of volition, and preoccupation were more common in schizophrenia. The mean age at onset was similar between patients with schizophrenia and ATPD. In keeping with findings in Europe and North America, there are clinical and sociodemographic differences between ATPD and schizophrenia; however, a different set of features differentiate between the two conditions in Nigerians.Item Prevalence of schizophrenia: recent developments(AOSIS, 2013) Esan, O.B.The long held view that schizophrenia affects about 1% of the population has been shown to be an overestimate and in fact derived from incorrect data.1 Also, for many years, it was believed that the prevalence of schizophrenia varied little between sites.2,3 It is in fact the case that the estimates of the prevalence of schizophrenia are characterized by a multiplicity of variations.1,4-6 The evidence for variations in incidence and prevalence of up to nine times in different populations as presented in recent systematic reviews has challenged such previously held views.1,5 Some of these variations are due to differences in the measures of disease frequency, while others are due to the time of the study.Item Epidemiology of schizophrenia-- an update with a focus on developing countries(Taylor & Francis, 2012) Esan, O.B.; Ojagbemi, A.; Gureje, O.Developments over the past few decades in analytical epidemiological research in schizophrenia have challenged some long-held views about the disorder. For example, the conventional view that schizophrenia may have a favourable outcome in developing countries is currently being challenged by emerging empirical data. However, quality research from develop ing countries is still relatively scarce. In this article we review some major epidemiological fi ndings of schizophrenia with a focus on data from the developing world and within the context of the methodological issues and challenges associ ated with such studies.