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BackgroundThere is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians.MethodsA cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ) to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7) and 30% of low scorers (score < 7). Diagnosis of psychiatric disorders was based on DSM-IV criteria.In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment) while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity.ResultsIt was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p < 0.001). Following logistic regression, younger age of children, frequent hospital attendance and maternal parenting distress independently predicted psychiatric morbidity while child psychopathology and maternal parenting distress predicted functional impairment.ConclusionsChild psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of difficult cases to the child and adolescent psychiatric unit of the hospital.

Background The magnitude of sexual health problems and availability of treatment options in the local environment is yet to be documented; thus, there is an urgent need for this, as sexual dysfunction may be a real social and psychological problem, needing urgent attention. Objective The aim of this study was to investigate the prevalence of sexual dysfunction and pattern of sexual health seeking behavior, among secondary school teachers in Ilorin, Kwara State Nigeria. Methods 450 teachers were invited to complete an anonymous self-administered sociodemographic questionnaire, as well as three other instruments measuring human sexuality and general mental health status. Main Outcome Measures The survey instrument used were the International Index of Erectile Function (IIEF-5), a modified Sexual Activity Questionnaire (SAQ), and the General Health Questionnaire -30 (GHQ -30). Result were compared with established normative data, and validated cut-off scores that were available. Results A total of 417 teachers (93%) responded to the questionnaire. The following prevalence rates were found: female anorgasmia (40%), lubrication failure (30%), dyspareunia (12%), erectile dysfunction, premature ejaculation and male orgasmic disorder (23% each), loss of sexual desire (24%), sexual life dissatisfaction, and relationship dissatisfaction six months prior to interview (10% each), and GHQ-30 scores were significant in sexual dysfunction in both genders, except for female anorgasmia and premature ejaculation in males. However, a presence of psychiatric morbidity was significantly found in overall sexual life dissatisfaction, as well as relationship dissatisfaction. The pattern of sexual health help-seeking behavior showed that majority (53%) do not seek treatment. Of these 53%, many (44%) gave the reason that they thought it transient, ignorance of hospital treatment service (30%), and fear of stigma (26%); also, among those that sought treatment, 46% chose alternative medicine. Conclusion The prevalence of sexual dysfunctions found in this study is comparable to those reported in earlier Nigerian studies. Despite this and the significant “psychiatric morbidity” experienced in sexual difficulties, apparently no health services have been specially designed to address sexual dysfunction among the teacher's group or the general population at large. This study therefore draws urgent attention to the need for services geared towards alleviating sexual problems, more professional and patient education are recommended.

The study supports earlier ones in Nigeria that child psychiatric disorders are common in hospital patients, although differences may exist in pattern and types. It emphasizes the need to screen hospital patients for morbidity to ensure early detection and treatment of psychiatric disorders in childhood. This is to limit the period of illness and avoid its adverse effects on growth and development of the children and to reduce the risk of carrying over remediable problems in childhood into adulthood.