scholarly journals Symptom Profile and Severity in a Sample of Nigerians with Psychotic versus Nonpsychotic Major Depression

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Increase Ibukun Adeosun ◽  
Oyetayo Jeje

The therapeutic strategies in managing patients with psychotic major depression (PMD) differ from those with non-psychotic major depression (NMD), because of differences in clinical profile and outcome. However, there is underrecognition of psychotic symptoms in depressed patients. Previous studies in Western population suggest that certain symptom patterns, apart from psychosis which may be concealed, can facilitate the discrimination of PMD from NMD. These studies may have limited applicability to sub-Saharan Africa due to cross-cultural differences in the phenomenology of depression. This study compared the rates and severity of depressive symptoms in outpatients with PMD (n=129) and NMD (n=117) using the Structured Clinical Interview for Depression (SCID) and Hamilton Depression Rating Scale (HAM-D). Patients with PMD had statistically significantly higher rates of suicidal ideation, suicidal attempt, psychomotor agitation, insomnia, and reduced appetite. Patients with NMD were more likely to manifest psychomotor retardation and somatic symptoms. PMD was associated with greater symptom severity. On logistic regression analysis, suicidal ideation, psychomotor disturbances, insomnia, and somatic symptoms were predictive of diagnostic status. The presence of these symptoms clusters may increase the suspicion of occult psychosis in patients with depression, thereby informing appropriate intervention strategies.

BJPsych Open ◽  
2016 ◽  
Vol 2 (6) ◽  
pp. 385-389 ◽  
Author(s):  
Abiodun O. Adewuya ◽  
Bolanle A. Ola ◽  
Olurotimi A. Coker ◽  
Olayinka Atilola ◽  
Mathew P. Zachariah ◽  
...  

BackgroundTo combat the increasing rate of suicide, basic data on suicidal behaviours reflecting the uniqueness of the locality are needed in sub-Saharan Africa.AimsTo assess the prevalence of suicidal ideation and associated factors.MethodAdults (n=11 246) from the five administrative divisions of Lagos State completed questionnaires detailing suicidal ideation, socio-demographic details, common mental disorders (depression, anxiety and somatic symptoms), alcohol and psychoactive substance use disorders and disability.ResultsThe weighted prevalence of current suicidal ideation was 7.28% (s.e. 0.27). Independently associated factors were older age, being female, not married, low occupational group, depression, anxiety, somatic symptoms and disability.ConclusionsDespite the validity of cross-national surveys, there is need for individual countries to generate complementary local data to explain variability in rates and risk factors in order to plan for suicide prevention or develop timely and effective response.


Author(s):  
Roslyn Law

Chapter 2 discusses complicated grief, and how the IPT therapist selects grief as an interpersonal focus when the onset of the patient’s symptoms is associated with the death of a significant other and manifests in a bereavement-related depression. It covers how this reaction differs from the predictable sorrow associated with bereavement – the experience of deprivation and desolation. It examines how the DSM-IV echoes this distinction by excluding immediate bereavement reactions in making the diagnosis of major depression, and how clinicians may diagnose major depression only if symptoms persist for more than 2 months after the death or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.


Author(s):  
Emmanuel Nii-Boye Quarshie ◽  
Samuel Kofi Odame

AbstractSuicidal ideation is a critical risk for attempted suicide and eventual suicide. Little is known about suicidal ideation among rural adolescents in most sub-Saharan African countries. We aimed to estimate the 12-month prevalence of suicidal ideation and to describe some of the common and gender-specific associated factors among in-school adolescents in rural Ghana. We conducted a cross-sectional survey involving a random sample of 1101 in-school adolescents aged 10–19 years in a rural district in Eastern Ghana. The Suicidal Behavior Questionnaire-Revised was used to assess suicidal ideation. Overall, 25.1% participants (95% CI = 22.5–27.7), representing 28.3% females (95% CI = 24.7–32.2) and 21.5% males (95% CI = 18.0–25.2) reported suicidal ideation during the previous 12 months. Females who experienced personal and interpersonal adversities mainly outside the family context were likely to report suicidal ideation, while suicidal ideation among males was associated with conflict with parents. Regardless of gender, adolescents who reported exposure to a friend’s attempted suicide were about two times more likely to report suicidal ideation. The prevalence of suicidal ideation among adolescents in rural Ghana compares with in-school estimates from other countries within sub-Saharan Africa, but also underscores the need for targeted and universal prevention programmes and intervention efforts to mitigate the potential transition from suicidal ideations to suicidal attempts and eventual deaths by suicide among rural adolescents.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lisa Reber

Purpose Anecdotal accounts of suicide among temporary low-wage migrant workers in the UAE are numerous, but unofficial and qualitative accounts remain unexplored. This study aims to examine how the socio-environmental context can lead some low-wage migrants, irrespective of their nationality or culture, to contemplate suicide for the first time after arriving in the host country. Design/methodology/approach The findings draw from ten months of qualitative fieldwork (2015–2016) and in-depth interviews conducted with 44 temporary migrant workers from sub-Saharan Africa and South Asia, earning in the lowest wage bracket in Dubai. The study used a non-probabilistic, purposive sampling approach to select participants. Three criteria drove eligibility: participants had to reside in the UAE, be non-national and earn Dh1500 (US$408) or less a month. Otherwise, diversity was sought in regard to nationality, occupation and employer. Findings Eight (18%) of the 44 study participants interviewed admitted to engaging in suicidal thoughts for the first time after arriving in the UAE. The findings suggest that for low-wage migrants working in certain socio-environmental contexts, the religious, gendered or other cultural or group characteristics or patterns that may be predictors of suicide in migrants’ country of origin may become secondary or possibly even irrelevant when one is forced to survive under conditions that by most objective standards would be deemed not only oppressive but extremely exploitative and abusive. Originality/value This study contributes to understandings of how the emotional and psychological well-being of temporary foreign low-wage migrant workers can be impacted by the socio-environmental context of the host country. It is a first step in understanding the intimate thoughts of low-wage migrant workers on the topic of suicidality, furthering our understanding of suicidal ideation and the factors that can contribute to it.


2015 ◽  
Vol 207 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Lauren C. Ng ◽  
Catherine M. Kirk ◽  
Frederick Kanyanganzi ◽  
Mary C. Smith Fawzi ◽  
Vincent Sezibera ◽  
...  

BackgroundSuicide is a leading cause of death for young people. Children living in sub-Saharan Africa, where HIV rates are disproportionately high, may be at increased risk.AimsTo identify predictors, including HIV status, of suicidal ideation and behaviour in Rwandan children aged 10–17.MethodMatched case–control study of 683 HIV-positive, HIV-affected (seronegative children with an HIV-positive caregiver), and unaffected children and their caregivers.ResultsOver 20% of HIV-positive and affected children engaged in suicidal behaviour in the previous 6 months, compared with 13% of unaffected children. Children were at increased risk if they met criteria for depression, were at high-risk for conduct disorder, reported poor parenting or had caregivers with mental health problems.ConclusionsPolicies and programmes that address mental health concerns and support positive parenting may prevent suicidal ideation and behaviour in children at increased risk related to HIV.


2013 ◽  
Vol 75 (4) ◽  
pp. 331-339 ◽  
Author(s):  
Jeremy D. Cohen ◽  
Taylor Nichols ◽  
Jennifer Keller ◽  
Rowena G. Gomez ◽  
Alan F. Schatzberg ◽  
...  

CNS Spectrums ◽  
2009 ◽  
Vol 14 (8) ◽  
pp. 431-436 ◽  
Author(s):  
Arthur Kummer ◽  
Francisco Cardoso ◽  
Antonio Lucio Teixeira

ABSTRACTObjective: To assess the frequency of suicidal ideation and suicide attempts in patients with Parkinson's disease.Methods: The Mini International Neuropsychiatric Interview (MINI), Beck Depression Inventory (BDI), and Hamilton Rating Scale for Depression (HAM-D) were administered to 90 consecutive, non-demented Parkinson's disease patients. They were also submitted to a complete neurologic examination which included brief cognitive batteries, the Mini Mental Status Exam, and Frontal Assessment Battery. We analyzed the scores of the section of the MINI related to the risk of suicide as well as the specific questions of BDI and HAM-D concerning suicidal ideation.Results: No patient had ever attempted suicide. According to MINI, suicidal ideation was present in 13 patients (14.4%) with Parkinson's disease. All instruments assessed the risk of suicide in a similar way. Suicidal ideation was associated only with lower age (P=.022), lower age of Parkinson's disease onset (P=.021), panic disorder (P=.004), social anxiety disorder (P=.007), and major depression (P<.001). Logistic regression analysis indicated that major depression was the main predictor of suicidal ideation.Conclusion: Suicide attempts seem to be uncommon in Parkinson's disease, despite the fact that the rates of suicidal ideation are possibly elevated. Depression seems to be the most important predictor of suicidal ideation in Parkinson's disease.


2018 ◽  
Vol 40 (2) ◽  
pp. 85-92 ◽  
Author(s):  
Godspower O. Owie ◽  
Sunday O. Olotu ◽  
Bawo O. James

Abstract 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.


2018 ◽  
Vol 65 (1) ◽  
pp. 20-27 ◽  
Author(s):  
Annika Claire Sweetland ◽  
Andrea Norcini Pala ◽  
Jennifer Mootz ◽  
Jennifer Chien-Wen Kao ◽  
Catherine Carlson ◽  
...  

Background: In sub-Saharan Africa, mental and substance-related disorders account for 19% of all years lived with disability, yet the intersection between poverty and mental distress is poorly understood since most psychiatric research is conducted in high-income countries. Aims: To examine the prevalence of and associations between food insecurity, mental distress and suicidal ideation in three rural village clusters in sub-Saharan Africa. Method: Cross-sectional multivariate analysis of sociodemographic variables associated with mental distress and suicidal ideation in three countries. The sample included 1,142 individuals from three rural village clusters in Nigeria ( n = 380), Uganda ( n = 380) and Ghana ( n = 382). Food insecurity was measured based on the number of months in the previous year that the respondent’s family reported being ‘unable to eat two square meals per day’. Mental distress was assessed using the Kessler non-specific psychological distress scale (K6) and suicidal ideation was measured using an item from PRIME-MD. Other sociodemographic variables included gender, age, literacy and occupation. Results: The prevalence of individuals with moderate or severe mental distress in Nigeria, Uganda and Ghana were higher than previously reported in the literature: 35.5%, 30.8% and 30.4%, respectively, and suicidal ideation rates were 29.7%, 21.3% and 10.9%. No differences were observed in mental distress between men and women in any of the sites. Being a farmer (vs student or other) was protective for mental distress in two sites (Uganda and Ghana) but no other social indicators, such as age, gender, literacy and food insecurity, were significantly associated with mental distress. Risk for suicidal ideation differed across sites: it was associated with food insecurity in Nigeria, female gender in Uganda, and older age in Uganda. Conclusions: Mental distress and suicidal ideation were highly prevalent in three settings of extreme poverty across all groups, in ways that were not always consistent with the global literature. These findings suggest that more research is needed in to better understand the social etiology of mental distress in sub-Saharan Africa.


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