Open Access Original Research Article

Prevalence, Pattern, and Correlates of Use of Benzodiazepines and other Sedating Over the Counter Medications among Elderly Persons in a Nigerian Community

Ighoroje Maroh, Ogundele Adefolakemi, Onofa Lucky Umukoro, Babalola Emmanuel

International Neuropsychiatric Disease Journal, Page 1-10
DOI: 10.9734/INDJ/2018/42724

Aim: To determine the prevalence, pattern and correlates of use of benzodiazepines and other sedating over the counter medications in older persons in Abeokuta, an urban community in  Nigeria.

Methodology: The design was cross-sectional. It was carried out among 212 retired state civil servants who attended the monthly meetings of the Nigeria Union of Pensioners (Ogun state chapter, Abeokuta zone) between September and November 2016. Respondents were at least 60 years as at last birthday and provided information regarding benzodiazepine use (lifetime, previous 12 months and previous 30 days) and use of sedating (antihistamine) over the counter (OTC) medications (previous 12 months and 30 days).

Results: The mean age of respondents was 70.1 ± 7.1 years and the majority were males (81.6%). The rates of benzodiazepine use were: lifetime (41.5%); previous 12 months (34.9%); previous 30 days (23.1%). The most commonly used benzodiazepines in the last 30 days were diazepam (18.9%), bromazepam (16.5%), nitrazepam (9.9%) and lorazepam (3.3%). The rates of sedating OTC medication were: previous 12 months (49.5%); previous 30 days (36.8%). The most significant predictor variables of benzodiazepine use in the previous 30 days were: current alcohol use, current use of sedating OTC medications and daily use of medications to treat chronic medical conditions. Respondents in the ≥ 70 years category were less likely to have used a benzodiazepine in the past 30 days.

Conclusions: The rate of the use of benzodiazepines and sedating (antihistamine) OTC medications in the elderly is high. It is hoped that these findings will inform stakeholders of the extent and factors influencing hypnotic/sedative drug use in the elderly and lead to the formulation and implementation of policies and practices aimed at maintaining the health, independence, and function of older persons in Nigeria.

 

Open Access Original Research Article

Weight Gain and Obesity among Out-patients with Schizophrenia on Antipsychotic Medications in Uyo, South-South Nigeria

Jombo, Henry Effiong, Abasiubong Festus UdoBassey, Eniekop Godwin Phillip

International Neuropsychiatric Disease Journal, Page 1-9
DOI: 10.9734/INDJ/2018/42792

Background: Treatment of schizophrenia with antipsychotic medications is often associated with increased risks for weight gain, overweight and obesity but the associated risk factors in these patients are not fully known.

Objective: The aim of our study is to determine the prevalence of overweight and obesity in patients with schizophrenia on antipsychotic medications and the risk factors associated with it.

Methods: This was a cross-sectional study. One hundred and six subjects diagnosed with schizophrenia were recruited for the study. Demographic and anthropometric variables, fasting glucose profile and treatment variables were obtained and results analysed using SPSS version 20. Significance was set at P=.05.

Result: Study participants had a mean age of 34.67±8.8 years, 55.8% was male, and had a weight gain of 11.92±6.2 and mean BMI of 27.22±3.5. The prevalence of overweight and obesity was 62.3% and 20.8% respectively. The risk of weight gain and obesity in the study population was increased for all class of antipsychotic medication (typical or atypical) and was more likely with increased duration of antipsychotic medication use. There was no association of weight gain with age, and duration of illness.

Conclusion: Treatment with antipsychotic medications was associated with a significantly increased risk for weight gain and obesity. There is the need for routine weight monitoring during treatment with antipsychotic medications for management interventions which may include switching of medications.

 

Open Access Original Research Article

Views of Future Doctors on the Current Mental Health Clerkship Programme of a Nigerian University

Okwudili Obayi, Mark Ezeme, Charles Nwoga, Chidi Agbara, Adora Ahanotu, Anayo Odo, Afamefula Okeke

International Neuropsychiatric Disease Journal, Page 1-8
DOI: 10.9734/INDJ/2018/42662

Background: Mental illnesses are a major public health problem around the world and the prevalence and burden of common mental disorders is growing, especially in Nigeria with a long-standing history of economic instability and security challenges. The psychiatry clerkship can play an important role in influencing students' attitudes towards psychiatry, either positively or negatively. The experience gathered by students during the posting, as a result of input from psychiatric doctors (consultants and trainee psychiatrists), other mental health practitioners, and the patients themselves contributes to the acquired benefits.

Objective: This study aimed to assess the overall perception of a two-week psychiatry clerkship by students at a Nigerian university.

Methods: One hundred and nineteen fifth year medical students were interviewed after their Mental Health posting and administered a structured survey questionnaire.

Results:  A majority of the students found the posting interesting but only 28.6% expressed an interest in psychiatry for future specialization. Two main problems with the psychiatry rotation were mentioned: concurrent classroom lectures and the timing – immediately prior to comprehensive examinations in 4th MBBS subjects.

Conclusion: Because of the increasing global burden of mental disorders, an undergraduate medical students’ clerkship of adequate length in psychiatry is a sine qua non for all medical practitioners.

 

Open Access Original Research Article

Neuropsychological Rehabilitation in a Case of Dynamic Aphasia

Yulia Solovieva, Luis Quintanar

International Neuropsychiatric Disease Journal, Page 1-15
DOI: 10.9734/INDJ/2018/42633

Dynamic aphasia is considered to be a rare neuropsychological syndrome. Reports of cases of dymanic aphasia aren’t so frequent in literature. The objective of this work is to show the effects of the program for neuropsychological rehabilitation in a case of an adult patient with dynamic aphasia. The patient was a young left-handed woman who suffered bilateral damage in anterior cortical regions as a result of traumatic brain injury. The qualitative neuropsychological assessment established a clinical syndrome of dynamic aphasia (according to the classification proposed by A.R. Luria) together with severe spatial difficulties. The content for the neuropsychological program was created and applied 3 times per week during the period of 4 months, with the total of 40 individual sessions. The tasks of the program were carried out on different levels of actions, including material, perceptive and verbal levels. The guided activities were used during the work of rehabilitation. Therapist has always provided all necessary orientation, while the execution was divided between patient and the therapist. Examples of execution of tasks of neuropsychological assessment are presented before and after the work with the program. The results pointed out essential changes in speech production of the patient together with successful execution of tasks for visuo-spatial orientation. Positive changes were noticed in emotional sphere of the patient as she started to communicate in her family. High possibilities of neuropsychological rehabilitation together with neuroplasticity should be considered in cases of brain injury. We conclude that neuropsychological rehabilitation created on solid theoretical bases may improve significantly the level of life and social activity of patients with brain damage.

 

Open Access Original Research Article

Mean Platelet Volume in Depression and Anxiety Disorder- a Hospital Based Case-control Study

Swapna Bondade, Supriya ., H. S. Seema, B. K. Shivakumar

International Neuropsychiatric Disease Journal, Page 1-8
DOI: 10.9734/INDJ/2018/42988

Introduction: Depression and anxiety disorder are the common mental disorders. Serotonin (5-hydroxytryptamine [5-HT]) is a well-established neurotransmitter in the central nervous system (CNS). It has a role in the anxiety, depression, appetite, motor, cognitive and autonomic functions, platelet aggregation and regulation of vascular tone. As the CNS is difficult to access, peripheral platelet models are widely used as the indicators of central 5-HT metabolism; moreover, they are known to reflect central serotonergic function.  Mean platelet volume (MPV) is contemplated as the marker of platelet function. It is a measure of platelet size and a good indicator of platelet activity. In this backdrop the current study was carried out to evaluate the MPV in depression and anxiety disorders.

Methods: Consecutive 90 depressive disorder patients, 76 anxiety disorder patients, diagnosed according to DSM 5 criteria and 49 healthy control subjects were selected for the study.  Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D), MPV and platelet count were measured in all subjects.

Results: It was revealed that MPV was more in patients  with depression (9.73±1.23) and anxiety disorder (9.84±1.32) compared to the controls (8.773±0.44) and this difference was statistically significant (F=14.95, p<0.001). There was no statistical difference in the MPV values between the patients with depression and anxietydisorder. Negative correlation between MPV and platelet count was recorded.

Conclusion: This study suggests that increased MPV is associated with depression and anxiety disorders. Future research should be planned to investigate the effect of depression and anxiety disorders on MPV.