IntroductionCaring for a mentally ill family member is a challenging task. Caregivers who are first-degree relatives (FDR) are at a higher risk of experiencing the negative consequences of caregiving. This study was aimed at determining burden of care and its correlates in caregivers who are first-degree relatives of patients with schizophrenia.MethodsA dyad of 255 patients and caregivers was recruited. A socio-demographic questionnaire was administered to both. The GHQ-12 was used to screen for psychiatric morbidity in the FDRs. Caregiver's burden was assessed with the Zarit Burden Interview. Patients' illness severity and level of functioning were assessed using the Brief Psychiatric Rating Scale and the Global Assessment of Functioning scales respectively.ResultsThe mean ± SD age of caregivers and patients were 45.1 ±12.3 and 36.7 ±13.4 years respectively. About 49% of caregivers experienced high burden of care. Older caregiver's age (r = 0.179; p < 0.004) and greater illness severity (r = 0.332; p < 0.0001) in the patient had weak to moderate positive correlation with burden of care. Caregiver's burden also increased with poorer functioning of the patient (r = -0.467 p < 0.0001). Independent predictors of caregiver burden were low level of education of the caregiver (OR 2.45; 95% CI 1.27-4.73), psychiatric morbidity in the caregiver (OR 6.74; 95% CI 2.51-18.15) and poor patient functioning (OR 2.81; 95% CI 1.27-6.18).ConclusionCaregivers who are first-degree relatives of patients with schizophrenia experience varying degrees of burden of care during caregiving. Routine screening and early psychological intervention would help to ameliorate these negative consequences of caregiving.
Introduction Assessing adherence in schizophrenia facilitates interventions that optimize outcomes. Adherence rating questionnaires are feasible and non-intrusive; however, no validated measure exists in sub-Saharan Africa. We aimed to assess the psychometric properties of the 10-item Medication Adherence Rating Scale (MARS). Methods This was a cross-sectional study of a cohort of patients with schizophrenia (n=230). A sociodemographic questionnaire, the Mini International Neuropsychiatric Interview (MINI), Positive and Negative Syndrome Scale (PANSS), Scale for the Unawareness of Mental Disorder (SUMD) and the MARS were all administered by an interviewer. Results The MARS demonstrated good reliability (Cronbach’s alpha: 0.76). The scale was reducible to a 3-factor construct (1 – medication adherence behavior, 2 – attitude to taking medications, and 3 – negative side effects and attitude to psychotropics), with significant though weak external validity in relation to psychopathology (p<0.001) and insight (p<0.001). The first factor showed good internal consistency (α=0.80), comprising six items that could serve as a reliable proxy measure of adherence in place of the MARS Conclusion The MARS demonstrated fair psychometric characteristics in assessing adherence in patients with schizophrenia in this cohort. The scale may be useful in the dimensional assessment of medication adherence for schizophrenia in sub-Saharan African settings.
The APP rate reported from this study is high. Clinicians should be mindful of its impact on dosage and side-effect profiles as APP use is associated with negative symptoms and poor psychosocial functioning.
Objectives: This cross-sectional study aimed to assess the prevalence, factors, and consequences of physical violence by mentally ill patients against mental health professionals. Methods: 124 of 145 mental health professionals at a Nigerian neuropsychiatric hospital satisfactorily completed a questionnaire on their experiences with physical assault. Results: 77 (62.1%) staff had been assaulted during their whole career; 38 (30.6%) of them were assaulted in the past 12 months. The most common type of assault was pushing (32.9%). The most common antecedent event to assault was calming an aggressive patient (44.1%). In their whole career, 22.1% of assaulted staff sustained injuries that required medical attention; 42.4% of assaulted staff sometimes or frequently/always experienced posttraumatic stress disorder symptoms. Physical assault in the whole career was associated with older age (p = 0.04), longer years of practice (p = 0.01), and job dissatisfaction (p = 0.05). Conclusions: Physical violence encountered by mental health professionals at a Nigerian neuropsychiatric hospital is substantial. Policy review of staff safety, training, and support is recommended.
BackgroundNon-attendance to clinic appointments is associated with poorer treatment outcomes.
There is a dearth of information about missed first clinic appointments among patients
with schizophrenia in Nigeria.AimsTo determine the prevalence, correlates and reasons for missed first appointment among
out-patients with schizophrenia at the Federal Neuro-Psychiatric Hospital, Benin City,
Nigeria.MethodA cross-sectional descriptive study among 275 out-patients with schizophrenia, using
the Mini International Neuro-Psychiatric Interview and the Brief Psychiatric Rating
Scale.ResultsThe prevalence of missed first appointment was 31%. Higher BPRS score was associated
with missing the appointment. The main reasons for missed appointments were: forgetting
the appointment date and patient's refusal to come to the clinic.ConclusionsMissed first out-patient clinic appointment is common among patients with schizophrenia
at the study site, forgetting appointment dates being a common reason. Among other
recommendations, methods of reminding patients and caregivers of appointment dates at
the study location may need to be explored.Declaration of interestNone.
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