BackgroundBy September 2014, an outbreak of Ebola Viral Disease (EVD) in West African countries of Guinea, Liberia, Sierra Leone, Senegal and Nigeria, had recorded over 4500 and 2200 probable or confirmed cases and deaths respectively. EVD, an emerging infectious disease, can create fear and panic among patients, contacts and relatives, which could be a risk factor for psychological distress. Psychological distress among this subgroup could have public health implication for control of EVD, because of potential effects on patient management and contact tracing. We determined the Prevalence, pattern and factors associated with psychological distress among survivors and contacts of EVD and their relatives.MethodsIn a descriptive cross sectional study, we used General Health Questionnaire to assess psychological distress and Oslo Social Support Scale to assess social support among 117 participants who survived EVD, listed as EVD contacts or their relatives at Ebola Emergency Operation Center in Lagos, Nigeria. Factors associated with psychological distress were determined using chi square/odds ratio and adjusted odds ratio.ResultsThe mean age and standard deviation of participants was 34 +/ - 9.6 years. Of 117 participants, 78 (66.7 %) were females, 77 (65.8 %) had a tertiary education and 45 (38.5 %) were health workers. Most frequently occurring psychological distress were inability to concentrate (37.6 %) and loss of sleep over worry (33.3 %). Losing a relation to EVD outbreak (OR = 6.0, 95 % CI, 1.2–32.9) was significantly associated with feeling unhappy or depressed while being a health worker was protective (OR = 0.4, 95 % CI, 0.2–0.9). Adjusted Odds Ratio (AOR) showed losing a relation (AOR = 5.7, 95 % CI, 1.2–28.0) was a predictor of “feeling unhappy or depressed”, loss of a relation (AOR = 10.1, 95 % CI, 1.7–60.7) was a predictor of inability to concentrate.ConclusionsSurvivors and contacts of EVD and their relations develop psychological distress. Development of psychological distress could be predicted by loss of family member. It is recommended that psychiatrists and other mental health specialists be part of case management teams. The clinical teams managing EVD patients should be trained on recognition of common psychological distress among patients. A mental health specialist should review contacts being monitored for EVD for psychological distress or disorders.

BackgroundSnakebite though neglected, affects 5 million people yearly. More neglected is the psychological effect of envenomation. We determined prevalence and pattern of depression among patients admitted into snakebite wards of Kaltungo General Hospital Nigeria, and percentage recognized by clinicians. We also assessed for factors associated with depression.MethodsIn a descriptive hospital based study, we used Patient Health questionnaire (PHQ-9) to make diagnosis of depression among the patients. We reviewed patients’ clinical records to determine clinicians’ recognition of depression.ResultsOf 187 interviews analyzed, 47 (25%) had depression with none recognized by attending clinicians. Patients with snakebite complications (odd ratio [OR] 3.1, 95% CI 1.1–8.5), and previous history of snakebites (OR 2.7, 95% CI 1.1–6.1) were associated with mild depression. Worrying about family welfare (OR 31.5, 95% CI 6.5–152.9), financial loss (OR 14.6, 95% CI 1.8–121.5) and time loss (OR 14.6, 95% CI 1.8–121.5), past history of snakebites (OR 8.3, 95% CI 1.9–36.5) and lower income (Mean difference −25,069 [84 USD], 95% CI 35,509 [118 USD]–14,630 [49 USD]) were associated with severe depression.ConclusionA quarter of in-patients of snakebite wards of the general hospital had comorbid depression that went unrecognized. Independent predictors of depression such as past history of snakebite, worrying about relations and having snakebite complications could help clinicians anticipate depression among patients. We recommend training of clinicians in the hospital on recognition of common psychological disorders like depression.

This study examines, retrospectively, the trends and factors associated with the use of seclusion over a five-year period in a regional secure unit located within a large psychiatric hospital that serves the population of North Cheshire. Ninety-four patients (15.3% of total admissions to the unit) spent some time in seclusion on 186 occasions. The average time spent in seclusion was 85 minutes (minimum 15 minutes and maximum 10 hours). Sixty-seven per cent of patients were secluded once, 20% secluded twice, and 13% more than three times. Patients with a clinical diagnosis of personality disorder (11.4%) accounted for 44.2% of seclusions whereas those with a defined mental disorder (55%) accounted for 35% of all seclusions. The rate of seclusion, characteristics of secluded patients, reasons, and average duration spent in seclusion, did not vary significantly over the study period, despite the significant reduction of the unit's admission rate from 150 to 63 per year. The consistent and regular occurrence of the practice over a five-year period may suggest that seclusion of some disturbed patients will inevitably continue to be used as an effective intervention and, probably at times, the only acceptable method that may ensure the safety of patients and staff.

This study reports the demographic and social characteristics and level of psychological dysfunction in regular khat users compared with matched non-users. The results indicate that khat users resemble non-users on a number of psychosocial variables and GHQ scores, with no evidence to suggest higher morbidity amongst users. The two groups appear to differ only in the level of their use of nicotine and also in their perception of the harmful effects associated with khat use.

High rates of psychiatric disorders, particularly major depression, alcoholism, drug-use disorder and antisocial personality disorder in the relatives of opiate-dependent patients compared with normal controls, have been reported in some previous studies. This study was designed to evaluate the prevalence rates of drug-use and other psychiatric disorders in the first-degree relatives of opiate-dependent patients and compare these with rates in the first-degree relatives of surgical and psychiatric patients. A case-control study was conducted to compare the prevalence of psychiatric and drug-use disorders (which were estimated by the Family History Method) in 241 biological first-degree relatives of 50 opiate-dependent patients to that in 235 and 222 first-degree relatives of 50 surgical and 50 psychiatric patients respectively. The main outcome measure was the relative risk (expressed as odds ratio) of psychiatric and drug-use disorders. First-degree relatives of opiate-dependent patients were found to have significantly higher rates of drug-use and antisocial personality disorders, compared with relatives of surgical and psychiatric probands. The odds ratio for alcoholism appeared significantly higher only in first-degree female relatives of opiate users, suggesting effect modification by sex. The study provides further evidence for the higher rate of drug-use disorder in the first-degree relatives of opiate-dependent patients. These findings suggest that familial drug-use disorder contributes to a vulnerability to opiate misuse. Implications of these findings for the classification and treatment of opiate dependence are discussed.