Psychiatry
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Item The natural history of insomnia in the Ibadan study of ageing(Oxford University Press, 2011) Gureje, O.; Oladeji, B.D.; Abiona, T.; Makanjuola, V.; Esan, O.B."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 Chronic pain conditions and depression in the Ibadan Study of Ageing(Elsevier Inc, 2011) Oladeji, B.D.; Makanjuola, V.A.; Esan, O.B.; Gureje, O."Background—Chronic pain is quite common in the elderly and is often associated with co morbid depression, limitation of functioning and reduced quality of life. The aim of this study was to ascertain whether there is a differential risk of depression among persons with pain in different anatomical sites and to determine which pain conditions are independent risk factors for depression. Methods—Data is from the Ibadan Study of Ageing (ISA), a community based longitudinal survey of persons aged 65 years and older from eight contiguous Yoruba Speaking states in Nigeria (n = 2152). Data was collected in face-to-face interviews; depression was assessed using the World Mental Health initiative version of the Composite International Diagnostic Interview (CIDI) while chronic pain was assessed by self-report (response rate = 74%). Results—Estimates of persistent pain (lasting more than 6 months), in different anatomical sites range from 1.3% to 12.8%, with the commonest being joint pains (12.8%), neck or back (spinal) pain (7.6%) and chest pain (3.0%). Significantly more pain conditions were reported by females and by respondents who were aged over 80 years. The risk for depression was higher in respondents with spinal, joint and chest pain. However, only chest pain was independently associated with depression after adjustments were made for pains at other sites and for functional disability. Conclusion—Our data suggests that, among elderly persons, there is a differential association of depression with chronic pain that is related to the anatomical site of the pain."