Scholarly works in Psychiatry

Permanent URI for this collectionhttps://repository.ui.edu.ng/handle/123456789/536

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Subject: search.filters.subject.psychosis

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    Spontaneous and emergent extrapyramidal syndromes in Black Africans with first-episode schizophrenia and first exposure to antipsychotics
    (Taylor & Francis, 2021) Ojagbemi, A.; Chiliza, B.; Bello, T.; Esan, O. B.; Asmal, L.; Emsley, R.; Gureje, O.
    Background: Persons of African ancestry are thought to carry a higher risk for extrapyramidal syndromes (EPS) in schizophrenia. Aim: We investigated the phenomenon of spontaneous and treatment-emergent EPS in a sample comprising Xhosa (South Africa) and Yoruba (Nigeria) Africans with first-episode schizophrenia and first exposure to antipsychotics. Methods: The Extrapyramidal Symptom Rating Scale (ESRS) and a variety of validated tools were used for the assessment of participants before, and two-weekly after treatment with low dose flupenthixol decanoate. Participants were followed up for 12 months. Association of EPS with clinical characteristics was investigated using Pearson’s correlation and linear regression analyses. Results: Of 88 participants at baseline, 16 (18.1%) had at least one definite EPS prior to antipsychotic exposure and 34 (38.6%) had treatment-emergent EPS. While spontaneous Parkinsonism was associated with negative symptoms (r¼0.2, p¼0.043; b¼0.6, p¼0.043), treatment-emergent EPS demonstrated non-significant correlations with clinical characteristics. Apart from dyskinesia, the frequency of treatment-emergent EPS decreased over 12 months observation. Conclusion: These findings support the hypothesis suggesting that spontaneously occurring Parkinsonism in schizophrenia may be the motor spectrum of negative symptomatology. Future studies of this relationship may lead to early identification of patients who may be more sensitive to EPS.
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    Collaborative shared care to improve psychosis outcome (COSIMPO): study protocol for a randomized controlled trial
    (BioMed Central, 2017) Gureje, O.; Makanjuola, V.; Kola, L.; Yusuf, B.; Price, L.; Esan, O.B.; Oladeji, B.D.; Appiah-Poku, J.; Haris, B.; Othieno, C.; Seedat, S.
    Keywords Background: Psychotic disorders are a group of severe mental disorders that cause considerable disability to sufferers and a high level of burden to families. In many low- and middle-income countries (LMIC), traditional and faith healers are the main providers of care to affected persons. Even though frequently canvassed as desirable for improved care delivery, collaboration between these complementary alternative health providers (CAPs) and conventional health providers has yet to be rigorously tested for feasibility and effectiveness on patient outcomes. Methods/design: COSIMPO is a single-blind, cluster randomized controlled trial (RCT) being conducted in Nigeria and Ghana to compare the effectiveness of a collaborative shared care (CSC) intervention program implemented by CAPs and primary health care providers (PHCPs) with care as usual (CAU) at improving the outcome of patients with psychosis. The study is designed to test the hypotheses that patients receiving CSC will have a better clinical outcome and experience fewer harmful treatment practices from the CAPs than patients receiving CAU at 6 months after study entry. An estimated sample of 296 participants will be recruited from across 51 clusters, with a cluster consisting of a primary care clinic and its neighboring CAP facilities. CSC is a manualized intervention package consisting of regular and scheduled visits of PHCPs to CAP facilities to assist with the management of trial participants. Assistance includes the administration of antipsychotic medications, management of comorbid physical condition, assisting the CAP to avoid harmful treatment practices, and engaging with CAPs, caregivers and participants in planning discharge and rehabilitation. The primary outcome, assessed at 6 months following trial entry, is improvement on the Positive and Negative Symptom Scale (PANSS). Secondary outcomes, assessed at 3 and 6 months, consist of levels of disability, experience of harmful treatment practices and of victimization, and levels of perceived stigma and of caregivers’ burden. Discussion: Information about whether collaboration between orthodox and complementary health providers is feasible and can lead to improved outcome for patients is important to formulating policies designed to formally engage the services of traditional and faith healers within the public health system.
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    Acute and transient psychotic disorder (ATPD) in a developing country
    (SAGE Publications, 2014) Esan, O.B.; Fawole, O.I.
    Background: Acute and transient psychotic disorders (ATPDs) are relatively under-researched. There is therefore a dearth of information on the disorders especially in developing countries, where they have been shown to be relatively common. Aim: To describe the socio-demographic and clinical characteristics of patients with ATPD, as well as to examine the factors that are associated with early recovery in patients with ATPD in a developing country. Methods: A review of 124 cases of untreated first episode of ATPD that presented at the University College Hospital, Ibadan, Nigeria over a five-year period. Results: Of the new cases that presented at the psychiatry department of the hospital, 10.1% were ATPDs. There was no significant difference between the proportions of males and females presenting at the hospital (50.8% vs 49.2%). Mean age at presentation was 29.5 (SD = 9.6) years, while the mean duration of illness before presentation was 7.3 (SD = 6.1) days. Female gender was significantly associated with earlier recovery (p= .047). Conclusion: ATPDs are common in developing countries. The epidemiology in developing countries is probably different from that of the developed countries.