Open Access Case Study

Safety of Repeated Twice-daily 30 Minutes of 2 mA tDCS in Depressed Patients

Ulrich Palm, Bianka Leitner, Wolfgang Strube, Alkomiet Hasan, Frank Padberg

International Neuropsychiatric Disease Journal, Page 168-171
DOI: 10.9734/INDJ/2015/19719

Aims: Transcranial direct stimulation (tDCS) is recently discussed as a therapeutic option in psychiatric disorders and has brought preliminary convincing results in the treatment of depressive disorders. Hence the optimal stimulation parameters still remain elusive as randomized controlled trials over last years used divergent stimulation protocols and duration, frequency, and current strength still have to be standardized.

Presentation of Cases: In this case series we report on the safety of twice daily 30 min tDCS at 2 mA over longer stimulation periods and interval treatment. Six patients (mean age 59.5±22.3, age range 29-87 years) with major depressive disorder received 20 to 31 tDCS treatments within 14 and 50 days, including acute treatment series and maintenance treatment. In the majority of participants, tDCS exerted antidepressant effects. tDCS was well tolerated and there were no clinically relevant adverse events.

Discussion: These preliminary data suggest safety and tolerability of twice-daily 30 min tDCS even in a prolonged protocol.

Conclusion: tDCS is gaining growing importance as a therapeutic tool in neuropsychiatric disorders and seems to be safe even when applied extensively.

Open Access Original Research Article

Evaluation of Pain and Anxiety Levels Related to Diagnostic Punch Biopsy in Dermatology Outpatients: A Pilot Study

Nilay Duman, Nagihan Saday Duman, Seval Doğruk Kaçar, Pınar Özuğuz

International Neuropsychiatric Disease Journal, Page 140-144
DOI: 10.9734/INDJ/2015/19500

Aim: Literature data on the anxiety levels and pain perception during punch biopsy are lacking. Thus, the aim of the present study is to evalute the anxiety levels and pain perception during punch biopsy.

Study Design: This is a prospective, single-center pilot study conducted with the approval of the institutional review board.

Place and Duration of Study: Department of Dermatology, Afyon Kocatepe University, between May 2015 and June 2015.

Methodology: This study included 40 dermatology outpatients underwent a punch biopsy. Demographic data, biopsy site, and previous history of any interventional procedure were noted. Pre- and post-procedural anxiety levels were assessed using the State-Trait Anxiety Inventory-1, and perception about pre-procedural waiting period and pain perception during biopsy were assessed via 10-point visual analog scales. Furthermore, the association between anxiety and pain levels, and perceived waiting periods were investigated.

Results: In all, 60% of the patients were female (mean age: 43.3±16.3 years). The mean pre-procedural anxiety score was 41.3±10.1. The mean pain score was 3.45±2.8. Pain scores did not correlate with pre-procedural anxiety scores (P = 0.104). However, pre-procedural waiting period scores correlated positively with pre-procedural anxiety level (P = 0.028) and pain scores (P < 0.001).

Conclusions: The punch biopsy was associated with some pain and anxiety. And the perceived waiting period affected pain and anxiety level. Thus, shortening pre-procedural waiting periods may help in relieving pain and anxiety.


Open Access Original Research Article

Prevalence of Diabetes Mellitus among Psychotropic Drug Naive Patients with Psychiatric Disorders at Federal Neuro-Psychiatric Hospital Barnawa, Kaduna

S. Y. Olatunbosun, A. M. Musa, I. U. Edward, F. T. Nuhu, T. L. Sheikh

International Neuropsychiatric Disease Journal, Page 145-152
DOI: 10.9734/INDJ/2015/16918

Background: It has been established that diabetes mellitus occurs frequently among psychiatric patients; however, little is known about diabetes mellitus among psychotropic drug naive patients with psychiatric disorders in Nigeria.

Objectives: This is to determine the prevalence and socio-demographic correlates of diabetes mellitus among psychiatric patients in Kaduna, Northern Nigeria.

Method: This study is a case control study involving 250 psychotropic drug naive patients who attended the Assessment and Emergency unit of Federal Neuro-psychiatric Hospital, Kaduna, Nigeria for the first time between November 2012 and December 2013 and 250 apparently normal individuals. The fasting blood glucose (FBG) level of both the patients and the apparently normal individuals were measured using enzymatic oxidation method and those whose FBG values were above normal range were repeated one or more times.

Results: The mean ages of the patients and the control individuals were 32.7 (±4.6) and 38.6 (±5.8) years respectively. Thirty-two patients (12.8%) were found to be diabetic compared to the control in which 14 (5.6%) were found to be diabetic (p value < 0.001). Among the 32 patients who were diabetic, 10 (4.0%) were female, 22 (8.8%) were male and 28 (11.2%) patients were within 18 and 60 years old. Seventy-one (28.4%) of the 250 patients (and /or their relatives) did not know their diabetes history compared to the control group whereas 18 (7.2%) individuals did not know their diabetes history.

Conclusion: Diabetes mellitus is more common among psychotropic drug naive psychiatric patients than the general population, highest incidence of diabetes mellitus among mentally-ill patients is found within the ages of 18 and 60 years and one out of about four mentally-ill patients (and/or their relatives) did not know about their sugar level, neither did they know if they do or do not have diabetes in their extended family. These should therefore be borne in mind in patient’s evaluation and management.


Open Access Original Research Article

Adolescents’ Disclosure of Sexual Violence Victimization in Nigeria: Prevalence, Barriers and Mental Health Implications

Increase Ibukun Adeosun

International Neuropsychiatric Disease Journal, Page 153-160
DOI: 10.9734/INDJ/2015/19291

Aim: Despite the adverse mental health consequences of sexual violence, the majority of cases are unreported by victims. Non-disclosure prevents access to appropriate therapeutic and legal interventions. The design of interventions to facilitate reporting of sexual abuse is hinged on the recognition of the barriers to reporting. The current study assessed the prevalence of disclosure and barriers to disclosure among adolescent victims of sexual violence in Lagos, Nigeria. 

Study Design and Methodology: Using a cross-sectional study design, self-reported questionnaires designed to assess sexual violence, disclosure of victimization and barriers to disclosure were administered to 220 adolescents attending a public co-educational secondary school in Lagos, south-West Nigeria. The findings are discussed in the context of their mental health implications.

Results: The mean age of the participants was 15.8 (±1.2) years, and 58.2% were males. Only 9.2% of the victims of sexual violence ever reported to anyone. Frequently reported barriers to disclosure were stigma (78.9%), consideration of discussion about sex as taboo (73.7%), fear of parents/ authority figures (76.3%), mistrust of law enforcement agencies (71.1%) and fear of perpetrators (63.2%). Other reported barriers include ignorance that the act constituted sexual abuse (34.2%), self-blame/guilt (31.6%) and fear of not being believed (36.8%).

Conclusion: There is an unmet need for interventions to facilitate reporting of sexual violence by victimized adolescents. Such interventions must address stigma, debunk myth, promote sexual education and ensure appropriate response of legal and social institutions to victims in order to restore public confidence.


Open Access Original Research Article

Community Members’ Perception of Epilepsy and their Attitude towards Persons Living with Epilepsy Disorders in a Rural Community of Bayelsa State, Nigeria

Izibeloko O. Jack-Ide, Agnes E. Maliki, Olayinka Onasoga

International Neuropsychiatric Disease Journal, Page 161-167
DOI: 10.9734/INDJ/2015/19472

Aims: Studies on perceptions and attitudes towards people with epilepsy have focused mainly on students/teachers in the south and Northern Nigeria. This study aimed at assessing community members’ perceptions and attitudes towards epilepsy and persons living with epileptsy disorders. Study Design: A cross sectional survey and descriptive design using a convenience sampling technique was used to collect data.

Place and Duration of Study: The study took place in a rural community of Bayelsa State, Nigeria between November 2014 and February 2015.

Methodology: A pre-tested structured face-face questionnaire was administered to 120 community members that were randomly selected from each of the sixteen compounds in the community (72 men, 48 women, age range 18-41 and above).

Results: Majority (50%) has heard about epilepsy, 13.3% know it as a brain disorder,  32.5% say it is hereditary, 46.7% believe epilepsy can be caused by supernatural powers, 55% thinks epilepsy is a highly contagious disease and transferable, 55.8% will not take a person with epilepsy to the hospital during a seizure attack, 73.3% said it is unwise for parents to send children with epilepsy to school for fear of ridicule by schoolmates, 100% will not marry neither allow their children marry any person with epilepsy and 63.3% will not disclose to their children’s spouses before marriage if son/daughter has epilepsy.

Conclusion: Negative perceptions and attitude is strongly upheld in study environment, and may be hindrance to proper treatment and social interactions. Community mobilization campaigns are advocated to improve the quality of life of persons suffering from epilepsy and counteract misconceptions attached to the disorder.