IntroductionSub-optimal adherence constitutes a significant impediment to the management of severe mental illnesses (SMIs) as it negatively impacts on the course of the illness and the treatment outcome. In this study, the levels of adherence, prevalence and the predictors of sub-optimal adherence were assessed in a sub-Saharan African setting.MethodsThree hundred and seventy (370) respondents with diagnoses of schizophrenia, bipolar disorder or severe depression were randomly enrolled and interviewed at the out-patient department of the Federal Neuropsychiatric Hospital, Maiduguri in northeastern Nigeria. An anonymous sociodemographic questionnaire and a clinical proforma designed by the authors, Oslo social support scale and the 8-item Morisky Medication Adherence Scale (MMAS-8) were used for data collection.ResultsThe prevalence of sub-optimal adherence was 55.7%. The independent predictors of sub-optimal adherence were; seeking for traditional/ spiritual treatment (Odds Ratio (O.R.) = 6.523, 95% C.I. = 3.773 - 11.279, P = < 0.001), male gender (O.R. = 3.307, 95% C.I. = 1.907 - 5.737, P = < 0.001), low levels of insight (O.R. = 1.753, 95 C.I. = 1.220 - 2.519, P = 0.002), and low social support levels (O.R. = 1.528, 95% C.I. = 1.097 - 2.129, P = 0.012).ConclusionBased on the outcome of the study, we recommend the development of psycho-educational programmes on adherence and the active involvement of the relations and significant others in the management of patients with SMIs in sub-Saharan Africa.

There is limited availability of mental health services in Nigeria, and indeed most of Africa. Available services are also often under-utilized because of widespread ignorance and supernatural beliefs about the etiology of mental illnesses. The consequence, therefore, is a long and tedious pathway to care for the mentally ill, especially children and adolescents. This was a study of all new patients, aged 18 years and below, presenting over a 6 month period in 2009 (January – June) at the outpatient clinic of a tertiary psychiatric facility in northern Nigeria. A socio-demographic questionnaire was utilized, along with a record of the clinician’s assessment of diagnosis for 242 patients. Subjects who had been withdrawn from school, or any previously engaged-in activity for longer than 4 weeks on account of the illness, were recorded as having disability from the illness. The children were aged 1-18 years (mean=12.3; SD=5.2) with males accounting for 51.7% (125) while 14.5% of the females (n=117) were married. Two thirds (64.5%) of the patients had been ill for longer than 6 months prior to presentation. One hundred and forty four subjects (59.5%) had received no care at all, while 36.4% had received treatment from traditional/religious healers prior to presentation. The most disabling conditions were ADHD (80%), mental retardation (77.8%), epilepsy (64.1%) and psychotic disorders (50%). There is urgent need for extending mental health services into the community in order to improve access to care and increase awareness about effective and affordable treatments.

Background:The impact of seizure disorder on people living with epilepsy (PWE) is worsened by the occurrence of comorbid psychiatric disorders, such as depression, which have been found commonly in PWE. Despite the dire consequences comorbid depression has on PWE, it still remains underdiagnosed and undertreated.Objective:To determine the prevalence of depression and associated clinical factors in PWE in Northwestern Nigeria.Materials and Methods:A total of 255 consecutive patients with epilepsy aged 18 years and above, from two health facilities, were recruited in this cross-sectional study. Following completion of a structured proforma detailing sociodemographic and seizure characteristics, Mini International Neuropsychiatric Interview was administered to diagnose depression in the patients.Results:A total of 255 patients, with a mean age of 32 years (standard deviation = 1.31), comprising 147 (57.6%) males and 108 (42.4%) females were studied. Majority (79.2%) of the patients had primarily generalized seizure type. Overall, depressive disorder was present in 52 (20.4%) patients. A significant association was found between previous hospitalization for epilepsy (P = 0.009), increased frequency of seizures, (P = 0.004), and prolonged duration of epilepsy, (P = 0.006). The independent predictors of depression included duration of epilepsy (P = 0.0001), previous hospitalization for epilepsy (P = 0.011), and frequency of seizures (P = 0.028).Conclusion:Depression was common in PWE. Female gender, previous hospitalization for epilepsy, increased frequency of seizures and prolonged duration of epilepsy were associated with depression in PWE. Previous hospitalization for epilepsy, increased frequency of seizures, and prolonged duration of epilepsy were independent predictors of depression.

Depression is a highly prevalent disorder in the study subjects. Based on these findings, it is recommended that a comprehensive psychiatric treatment strategy should be initiated using a biopsychosocial framework that includes psychopharmacological and psychotherapeutic intervention to reduce morbidity and mortality in affected patients.

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Background: Constraint induced movement therapy (CIMT) is a rehabilitation technique that has been reported to improve upper limb motor function. Its main components are constraint of the unaffected limb and task practice with the affected limb for specific periods of time. However, the optimal dose of task practice and its safety during acute stroke is not clear. This is because studies use different durations for task practice, and task practice during acute stroke in animals was reported to result in lesional expansion and subsequent functional deterioration. In animal models and human chronic stroke patients, high repetitions of task practice of ranging from 300–800 has been reported to be the number required for functional improvement. Whether this is possible in acute stroke is not clear. Aim: The aim of this case report was to investigate the feasibility of 320 repetitions of task practice during CIMT in a patient who had a stroke 8 days prior to the commencement of treatment. Method: The patient was a 55-year-old woman who was 8 days post stroke at the time of treatment commencement, with mild left upper limb motor impairment. The patient performed 320 repetitions of functional tasks divided between two sessions per day, 5 days a week, for a duration of 8 weeks. Result: The results showed a significant improvement in upper limb motor function at 2 weeks, which reached the level of minimally clinical important difference (MCID) at 4, 6 and 8 weeks post-intervention. Conclusion: It may be possible to administer high repetitions of task practice to acute stroke patients.

Background Earlier studies suggest that knowledge about Autism Spectrum Disorder (ASD) among healthcare workers in Nigeria is low. This present study assessed the knowledge of Nigerian final year medical students about symptoms of ASD and some other aspects of ASD. This is a cross sectional descriptive study that drew a total of seven hundred and fifty-seven (757) final year medical students from ten (10) randomly selected fully accredited medical schools out of a total of twenty-seven (27) fully accredited medical schools in Nigeria. Sociodemographic and Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaires were used to assess knowledge of final year medical students about ASD and obtain demographic information.ResultsOnly few, 218 (28.8 %) of the 757 final year medical students had seen and participated in evaluation and management of at least a child with ASD during their clinical postings in pediatrics and psychiatry. Knowledge and recognition of symptoms of ASD is observed to be better among this group of final year medical students as shown by higher mean scores in the four domains of KCAHW questionnaire. Knowledge about ASD varies across gender and regions. Misconceptions about ASD were also observed among the final year medical students.ConclusionsMore focus needs to be given to ASD in the curriculum of Nigerian undergraduate medical students, especially during their psychiatry and pediatric clinical postings.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1433-0) contains supplementary material, which is available to authorized users.

A B S T R A C TBackground: Different studies have reported various frequencies of electroencephalographic (EEG) abnormalities in patients with epilepsy. There is, however, a paucity of data on EEG in Nigeria; hence, the need for this study. Objective: The objective of the following study was to evaluate interictal EEG pattern in patients with epilepsy in Kano, Northwestern Nigeria. Subjects and Methods: A cross-sectional study involving the analysis of EEGs of consecutive patients with clinical diagnosis of epilepsy over a 5 year period at two diagnostic centers in Kano, northwestern Nigeria. Information on socio-demographic and seizure characteristics was obtained. The recordings from patients were obtained using the standard methods and interpreted by two of the investigators. The International Federation of Societies for Electroencephalography and Clinical Neurophysiology defi nition of interictal epileptiform discharges (interictal epileptiform activity [IEA]) was adopted for the study. Result: Out of 2219 patients referred for EEG at the two diagnostic centers during the study period, 2041 (92%) patients had a clinical diagnosis of epilepsy. Their age ranged between 0.04 and 75 years, with a mean age of 22.8 ± 14.9 years. Overall, EEG was abnormal in 1178 (57.7%), and 919 (45.1%) had an epileptiform pattern. A total of 1691 patients had hyperventilation (HV), and response to HV was unremarkable in 1286 (76%) of them. Out of 405 who had remarkable changes on HV; 302 had increase in epileptiform discharges, whereas 103 had abnormal discharges only on HV. Seventeen (89.5%) out of 19 patients with 3 Hz spike and wave complexes had activation by HV. The most common IEA were focal spike/sharp and wave and generalized spike/sharp and slow waves. More antiepileptic drug (AED) naive patients (678) than those that were on AED (500) had EEG abnormality and the difference was statistically signifi cant, P < 0.001. Conclusion:The study showed that the occurrence of interictal EEG abnormality in patients with epilepsy was about 58%. The proportion of interictal epileptiform discharges was 45% in routine fi rst EEG studies. Among those with epileptiform activity, generalized sharp and wave complexes and focal sharp and slow wave complexes were the most common fi ndings.