Psychiatry
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Item Traumatic events and suicidal behavior in the Nigerian survey of mental health and well-being(John Wiley & Sons, 2012) Uwakwe, R.; Oladeji, B. D.; Gureje, O.Objective: Not much is known about the role of different traumatic events in predicting suicidal outcomes. We investigated the association of specific traumatic events with different suicidal outcomes. Method: Data are from the Nigerian Survey of Mental Health and Well-Being, a multistage probability household survey of persons aged 18 years and over. Information on traumatic events and suicidal behaviours (ideation, plan and attempts) was collected in face-to-face interviews using the Composite International Diagnostic Interview (CIDI.3) from a subsample of the respondents (N = 2143). Results: At least one traumatic event was reported by 63% of the sample. Traumatic events were more likely to have been experienced by individuals with different suicidal outcomes, with a dose–response relationship between the number of traumatic events and suicide ideation. The risks of suicidal ideation were elevated among persons with a history of combat experience (OR 6.3 95% CI 1.8–21.8) and those with exposure to war (OR 4.2; 95% CI 1.6–10.6), while that of suicidal attempt was increased among persons with experience of interpersonal violence (OR 4.3; 95% CI 1.4–13.0). Conclusion: Traumatic events are common in the general population. This report highlights the role of traumatic events (especially those related to violence) in predicting suicidal behaviour.Item Determinants of length of stay in the psychiatric wards of the University College Hospital, Ibadan, Nigeria(2012) Oladeji, B. D.; Ogundele, A. T.; Dairo, M.Background: Inpatient care constitutes the most expensive component of psychiatric services and pressure is increasingly being mounted on clinicians to discharge patients early. With the advent of managed care in Nigeria, psychiatrists as well as other physicians will be faced with the challenge of having to justify patient’s length of hospital admission. This study was designed to examine the factors that influence the length of stay (LOS) in an acute psychiatric ward. Methods'. A list of all patients admitted to the psychiatric unit of the UCH for the twelve month period between June 1st 2006 and May 31st 2007 was compiled from the ward admission registers. Data were extracted from the patient’s case notes using specially designed data record forms. Results: There were a total of three hundred and seventy one (371) admissions made up of three hundred and thirty three (333) patients, out of which a total of 247 (74.5%) case notes were successfully reviewed. The most common diagnoses necessitating admission were schizophrenia and mood disorders. The mean LOS was 28.7 days and bed turnover for this period was 5.8. Factors found to be significantly associated with longer LOS include age, diagnosis, previous admissions and receiving electroconvulsive therapy with medication. These factors need to be considered in determining the period of hospitalization covered under managed care schemes.Item Parental mental disorders and suicidal behavior in the Nigerian survey of Mental health and well-being(Routledge, 2011-10) Oladeji, B. D.; Gureje, O.The objective of this study was to determine which parental mental disorders predict offspring suicidal behavior in a general adult population sample of a sub-Saharan African country. The World Health Organization Composite International Diagnostic Interview, version 3 was used to assess respondents’ suicidal behaviors as well as psychopathology in their parents. The effects of parental disorders in predicting offspring suicide ideation and attempts were examined in a series of bivariate and multivariate models. Sections on suicidality were dministered to the entire sample (n=6752), but associations with parental psychopathology were examined in a subsample of respondents (n=2143). Lifetime prevalence (95% confidence interval) of suicide ideation, plans, and attempts was 3.2% (1.4–6.5), 1.0% (0.4–7.5), and 0.7% (0.5–1.0) respectively. Parental panic disorder and substance abuse were associated with suicide ideation in offspring, but only parental panic disorder was linked to suicide attempts. Parental panic disorder predicted the onset and persistence of suicide ideation and attempts and also which persons with suicide ideation go on to make a suicide attempt. This study further affirms findings from previous studies of the role of disorders characterized by anxiety and impulse control in suicide attempts and as being a probable link in the transmission of suicidal behavior to offspring.Item The natural history of insomnia in the Ibadan study of ageing(2011) Gureje, O.; Oladeji, B. D.; Abiona, T.; Makanjuola, V.; Makanjuola, V.; Esan, O.Study Objectives: To determine the incidence and risk factors for insomnia among an under-studied population of elderly persons in Sub-Saharan Africa. Setting: Eight contiguous predominantly Yoruba-speaking states in south-west and north-central Nigeria representing about 22% of the national population. Participants: 1307 elderly community-dwelling persons, aged 65 years and older. Measurements: Face-to-face assessment with the Composite International Diagnostic Interview, version 3 (CIDI.3) in 2007 and 12 months later in 2008 to determine the occurrence and risk factors of incident and persistent insomnia, defined as syndrome or symptom. Results: The incidence of insomnia syndrome in 2008 at 12 months was 7.97% (95% CI, 6.60–9.60), while that of insomnia symptom was 25.68% (22.68-28.66). Females were at elevated risk for both syndrome and symptom. Among persons with insomnia symptom or syndrome at the base¬line, 47.36% (95% CI 43.07–51.68) continued to have it one year later. Decreasing economic status was associated with increasing incidence of insomnia. Persons with chronic medical conditions at baseline were at increased risk for new onset of insomnia. Compared to persons with the lowest body mass index (BMI) (< 18.5), those with higher BMI were at elevated risk for persistence of their insomnia, with those in the obese range (≥ 30) having a 4-fold risk. Conclusions: There is a high incidence and chronicity of insomnia in this elderly population. Persons with chronic health conditions are particularly at risk of new onset as well as persistence of insomnia.Item Incidence and risk factors of late life depression in the Ibadan study of ageing(Cambridge University Press, 2011) Gureje, O.; Oladeji, B. D.; Abiona, T.Background. We present the incidence and risk factors for major depressive disorder (MDD) among community dwelling elderly Nigerians. Method. A cohort study of persons aged o65 years residing in eight contiguous Yoruba-speaking states in southwest and north-central Nigeria was conducted between November 2003 and December 2007. Of the 2149 baseline sample, 1408 (66%) were successfully followed up after approximately 39 months. Face-to-face in-home assessments were conducted with the World Health Organization (WHO) Composite International Diagnostic Interview, version 3 (CIDI.3) and diagnosis was based on the DSM-IV. Incident MDD was determined in the group with no prior lifetime history of MDD at baseline and who were free of dementia at follow-up (n=892). Results. During the follow-up period, 308 persons had developed incident MDD, representing a rate of 104.3 [95% confidence interval (CI) 93.3–116.6] per 1000 person-years. Compared to males, the age-adjusted hazard for females was 1.63 (95% CI 1.30–2.06). Lifetime or current subsyndromal symptoms of depression at baseline did not increase the risk of incident MDD. Among females, but not males, rural residence and poor social network were risk factors for incident MDD. Physical health status at baseline did not predict new onset of MDD. Conclusions. The finding of a high incidence of MDD among elderly Nigerians complements earlier reports of a high prevalence of the disorder in this understudied population. Social factors, in particular those relating to social isolation, constitute a risk for incident MDD.Item Traumatic events and posttraumatic stress symptoms among adolescents in Ibadan(College of Medicine, University of Ibadan, Nigeria, 2011) Oladeji, B. D.; Morakinyo, J. J.; Gureje, O.Little empirical data exist on the rates of exposure to traumatic events and its sequelae especially in adolescents. This study was designed to determine the lifetime prevalence of exposure to traumatic events and posttraumatic stress symptoms among adolescents in Ibadan, Nigeria. A sample of 786 boys and girls from 10 senior secondary schools located within Ibadan were interviewed using an adapted version of the Schedule for Affective Disorders and Schizophrenia (KSADS) to ascertain the prevalence of exposure to traumatic events and posttraumatic stress symptoms. Irrespective of gender, more than 40% reported lifetime exposure to at least one traumatic event. Commonly reported events were: receiving news of sudden injury, death or illness in a close family member or friend, being a victim or witness to a violent crime and physical abuse. About 2.4% of the sample met diagnostic criteria for posttraumatic stress disorder (PTSD). Female sex, exposure to more than one traumatic event, and sexual abuse were associated with increased risk for PTSD. The results of this study highlights the substantial risk for experiencing serious traumatic events by adolescents within the community, and a need for professionals involved in the care of adolescents to be more vigilant in screening for trauma related distress.Item The gateway hypothesis of substance abuse: an examination of its applicability in Nigeria general population(Informa Healthcare USA, Inc., 2010) Makanjuola, V. A.; Oladeji, B. D.; Gureje, O.The study aims to estimate the prevalence and predictors of not following the gateway theory. Respondents were selected from a multistage stratified clustered sampling of households in five of Nigeria’s six geopolitical regions. Interviews were conducted between February 2002 and May 2003 using the CIDI-version.3 with a total sample size (N) of 2,143. Cumulative incidence proportions of not following a gateway pattern were estimated with SUDAAN. Predictors of this were estimated using multivariate logistic regression models. The deviation from the normative sequence of drug use occurs albeit infrequently. The public health implications of this are discussed as well as the limitations of the findings.Item Family related adverse childhood experiences as risk factors for psychiatric disorders in Nigeria(Cambridge University Press, 2010) Oladeji, B. D.; Makanjuola, V. A.; Gureje, O."Adverse childhood experiences have been associated with a variety of mental health problems in adult life. Aims To examine whether this reported link between childhood experiences and mental health disorders in adult life applies in a Sub-Saharan African setting where cultural and family attributes may be different. Method A multistage random sampling was used in the Nigerian Survey of Mental Health and Well-Being (NSMHW) to select respondents for face-to-face interviews. Assessments of family-related adverse childhood experiences and lifetime mental health disorders were conducted with the Composite International Diagnostic Interview (CIDI 3.0). Results Almost half of the respondents had experienced an adverse childhood experience within the context of the family before they were 16 years of age. Associations between adverse childhood experiences and adult mental health disorders were few and were attenuated when clustering of adverse childhood experience and disorder comorbidities were accounted for. There was an elevated likelihood of adult substance use disorders among individuals who had experienced family violence and neglect or abuse. Parental psychopathology was associated with a significantly increased risk for developing mood disorders. Conclusions Adverse childhood experiences reflecting violence in the family, parental criminality and parental mental illness and substance misuse were more likely to have significant mental health consequences in adulthood"Item The gateway hypothesis of substance abuse: an examination of its applicability in Nigeria general population(Informa Healthcare USA, Inc., 2010) Makanjuola, V. A.; Oladeji, B. D.; Gureje, O.The study aims to estimate the prevalence and predictors of not following the gateway theory. Respondents were selected from a multistage stratified clustered sampling of households in five of Nigeria’s six geopolitical regions. Interviews were conducted between February 2002 and May 2003 using the CIDI-version.3 with a total sample size (N) of 2,143. Cumulative incidence proportions of not following a gateway pattern were estimated with SUDAAN. Predictors of this were estimated using multivariate logistic regression models. The deviation from the normative sequence of drug use occurs albeit infrequently. The public health implications of this are discussed as well as the limitations of the findings.Item Neuropsychological evaluation for persons with HIV and AIDS(Oxford University Press, 2017-05) Oladeji, B. D.; Robertson, K. R.