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Optimal mental health for achieving health security in Nigeria: a strategic blueprint
Published 2019Subjects: “…Mental health problems…”
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The association between childhood adversities and subsequent first onset of psychotic experiences: a cross- national analysis of 23 998 respondents from 17 countries
Published 2017Subjects: “…World Mental Health survey…”
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Collaboration Between Biomedical and Complementary and Alternative Care Providers: Barriers and Pathways
Published 2017Subjects: “…mental health and illness…”
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Page will reload when a filter is selected or excluded.- Mental health 9 results 9
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- 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. 2 results 2
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- Aims In low and middleincome countries (LMIC) in general and sub-Saharan African (SSA) countries in particular, there is both a large treatment gap for mental disorders and a relative paucity of empirical evidence about how to fill this gap. This is more so for severe mental disorders, such as psychosis, which impose an additional vulnerability for human rights abuse on its sufferers. A major factor for the lack of evidence is the few numbers of active mental health (MH) researchers on the continent and the distance between the little evidence generated and the policymaking process. Methods: The Partnership for Mental Health Development in Africa (PaMD) aimed to bring together diverse MH stakeholders in SSA, working collaboratively with colleagues from the global north, to create an infrastructure to develop MH research capacity in SSA, advance global MH science by conducting innovative public health relevant MH research in the region and work to link research to policy development. Participating SSA countries were Ghana, Kenya, Liberia, Nigeria and South Africa. The research component of PaMD focused on the development and assessment of a collaborative shared care (CSC) program between traditional and faith healers (T&FHs) and biomedical providers for the treatment of psychotic disorders, as a way of improving the outcome of persons suffering from these conditions. The capacity building component aimed to develop research capacity and appreciation of the value of research in a broad range of stakeholders through bespoke workshops and fellowships targeting specific skillsets as well as mentoring for early career researchers. Results: In the research component of PaMD, a series of formative studies were implemented to inform the development of an intervention package consisting of the essential features of a CSC for psychosis implemented by primary care providers and T&FHs. A cluster rand was next designed to test the effectiveness of this package on the outcome of psychosis. In the capacity building component, 35 early and midcareer researchers participated in the training workshops and several established mentor mentee relationships with senior PaMD members. At the end of the funding period, 60 papers have been published and 21 successful grant applications made. CONCLUSION: The success of PaMD in energising young researchers and implementing a cutting-edge research program attests to the importance of partnership among researchers in the global south working with those from the north in developing MH research and service in LMIC. 1 results 1
- Aims. Intermittent explosive disorder (IED) is characterised by impulsive anger attacks that vary greatly across individuals in severity and consequence. Understanding IED subtypes has been limited by lack of large, general population datasets including assessment of IED. Using the 17-country World Mental Health surveys dataset, this study examined whether behavioural subtypes of IED are associated with differing patterns of comorbidity, suicidality and functional impairment. Methods. IED was assessed using the Composite International Diagnostic Interview in the World Mental Health surveys (n = 45 266). Five behavioural subtypes were created based on type of anger attack. Logistic regression assessed association of these subtypes with lifetime comorbidity, lifetime suicidality and 12-month functional impairment. Results. The lifetime prevalence of IED in all countries was 0.8% (S.E.: 0.0). The two subtypes involving anger attacks that harmed people (‘hurt people only’ and ‘destroy property and hurt people’), collectively comprising 73% of those with IED, were characterised by high rates of externalising comorbid disorders. The remaining three subtypes involving anger attacks that destroyed property only, destroyed property and threatened people, and threatened people only, were characterized by higher rates of internalising than externalising comorbid disorders. Suicidal behaviour did not vary across the five behavioural subtypes but was higher among those with (v. those without) comorbid disorders, and among those who perpetrated more violent assaults. Conclusions. The most common IED behavioural subtypes in these general population samples are associated with high rates of externalising disorders. This contrasts with the findings from clinical studies of IED, which observe a preponderance of internalising disorder comorbidity. This disparity in findings across population and clinical studies, together with the marked heterogeneity that characterizes the diagnostic entity of IED, suggests that it is a disorder that requires much greater research. 1 results 1
- Anglophone 1 results 1
- Background: Healthcare professionals, such as pharmacists, play critical roles in the management of mental disorders by assessing the potential for adverse reactions, providing medication counseling, and medication review optimize treatment regimens. Objectives: This study aims to assess the knowledge of pharmacy students in a Nigerian university regarding psychotropic medicines and their attitude towards providing pharmaceutical care to patients with anxiety. Method: A cross-sectional web-based survey was conducted in May 2021 among fourth- and fifth-year pharmacy students in a Nigerian university. The data were summarized using descriptive statistics, such as frequencies and percentages. Chi square was utilized to examine the association between the demographic characteristics and the respondents' overall knowledge and attitude. Results: The response rate was 85%, as 126 responses were received. About half of the respondents 69 (54.8%) reported that they have received training on psychotropic medicines and 9 (9.1%) have been previously diagnosed with anxiety disorders. Only 53 (42.1%) and 71 (56.3%) of our respondents knew that escitalopram and alprazolam are categorized as anxiolytics respectively. Most respondents would like to talk to patients with anxiety about their medications 110 (87.3%), attend training on pharmaceutical care for patients with anxiety 103 (81.7%), and obtain a medication history for people with anxiety 113 (89.7%). Ninety-four (74.6%) pharmacy students would like to suggest prescription medication for a patient with anxiety and only 88 (69.8%) would like to correct any errors in prescription in any anxiety cases. Our findings also revealed that there is a significant association between the students’ attitude and year of study (p=0.038) and previous training on psychotropic medicines (p=0.004). Conclusion: Findings from this study suggested that participants require improved knowledge and training of psychotropic medicines. 1 results 1
- Background: There is relatively limited information on the risk factors and outcome of new onset Post stroke Anxiety (PSA) in Low- and Middle-Income Countries. We estimated incidence, cumulative incidence, risk factors and outcome of new onset anxiety in the first year of stroke among African stroke survivors. Methods: We analyzed the dataset of a completed clinical trial comprising patients enrolled to test an intervention designed to improve one-year blood pressure control among recent ( one month) stroke survivors in Nigeria. Anxiety was measured using the Hospital Anxiety and Depression Scale. Outcomes were assessed using the modified Rankin Scale (mRS), Community screening instrument for dementia (CSID) and Health Related Quality of Life in Stroke Patients (HRQOLISP-26). Results: Among 322 stroke survivors who were free of anxiety at baseline, we found a one-year cumulative incidence of 34% (95% CI = 28.6 39.3). Rates were 36.2% (95% CI =29.6 42.7) for men and 29.2% (95% CI =19.9 38.3) for women. In multivariate Cox regression analyses, haemorrhagic stroke type was associated with higher risk of new onset PSA (Hazard Ratio=1.52, 95% CI =1.01 2.29). New onset PSA was independently associated with cognitive [(mean difference (MD) in CSID scores=1.1, 95% C.I=0.2, 1.9)] and motor decline (MD in mRS scores= 0.2, 95% C.I= 0.4, 0.02), as well as poorer quality of life overtime (MD in total HRQOLISP-26 scores=3.6, 95% C.I=1.0, 6.2). Conclusion: One in 3 stroke survivors in Nigeria had PSA at one year. Clinicians in SSA should pay special attention to survivors of haemorrhagic stroke as they are at higher risk of incident anxiety and therefore its consequences. 1 results 1
- Background: Traditional and faith healers constitute an important group of complementary and alternative mental health service providers (CAPs) in sub-Sahara Africa. Governments in the region commonly express a desire to integrate them into the public health system. The aim of the study was to describe the profile, practices and distribution of traditional and faith healers in three sub-Saharan African countries in great need for major improvements in their mental health systems namely Ghana, Kenya and Nigeria. Materials and methods: A mapping exercise of CAPs who provide mental health care was conducted in selected catchment areas in the three countries through a combination of desk review of existing registers, engagement activities with community leaders and a snowballing technique. Information was collected on the type of practice, the methods of diagnosis and the forms of treatment using a specially designed proforma. Results: We identified 205 CAPs in Ghana, 406 in Kenya and 82 in Nigeria. Most (> 70%) of the CAPs treat both physical and mental illnesses. CAPs receive training through long years of apprenticeship. They use a combination of herbs, various forms of divination and rituals in the treatment of mental disorders. The use of physical restraints by CAPs to manage patients was relatively uncommon in Kenya (4%) compared to Nigeria (63.4%) and Ghana (21%). CAPs often have between 2- to 10-fold capacity for patient admission compared to conventional mental health facilities. The profile of CAPs in Kenya stands out from those of Ghana and Nigeria in many respects. Conclusion: CAPs are an important group of providers of mental health care in sub-Saharan Africa, but attempts to integrate them into the public health system must address the common use of harmful treatment practices. 1 results 1
- Background—Although there is robust evidence linking childhood adversities (CAs) and an increased risk for psychotic experiences (PEs), little is known about whether these associations vary across the life-course and whether mental disorders that emerge prior to PEs explain these associations. Methods—We assessed CAs, PEs and DSM-IV mental disorders in 23,998 adults in the WHO World Mental Health Surveys. Discrete-time survival analysis was used to investigate the associations between CAs and PEs, and the influence of mental disorders on these associations using multivariate logistic models. Results—Exposure to CAs was common, and those who experienced any CAs had increased odds of later PEs (OR =2.3, 95%CI=1.9–2.6). CAs reflecting maladaptive family functioning (MFF), including abuse, neglect, and parent maladjustment, exhibited the strongest associations with PE onset in all life-course stages. Sexual abuse exhibited a strong association with PE onset during childhood (OR= 8.5, 95%CI=3.6–20.2), whereas other CA types were associated with PE onset in adolescence. Associations of Other CAs with PEs disappeared in adolescence after adjustment for prior-onset mental disorders. The population attributable risk proportion (PARP) for PEs associated with all CAs was 31% (24% for MFF). Conclusions—Exposure to CAs is associated with PE onset throughout the life-course, although sexual abuse is most strongly associated with childhood onset PEs. The presence of mental disorders prior to the onset of PEs does not fully explain these associations. The large PARPs suggest that preventing CAs could lead to a meaningful reduction in PEs in the population. 1 results 1
- Caregiver 1 results 1
- Comorbidity 1 results 1
- Epidemiology 1 results 1
- Equity in health: Low and Middle-Income Countries 1 results 1
- Fitness exercises 1 results 1
- Health professionals 1 results 1
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