Open Access Case Study

Cognitive Behavioral Therapy for Kleptomania: A Case Study

Saad Riad El. Biomy

International Neuropsychiatric Disease Journal, Page 41-50
DOI: 10.9734/indj/2020/v14i330133

Kleptomania is a disabling impulse control disorder, that can be treated with cognitive behavioral therapy (CBT). This was achieved through the results of a case study. The presenting case is 20-year-old college student. The complaint at the first interview was that she was stealing from others during childhood, with other symptoms matching DSM-5 for diagnosis of kleptomania.

Study aims to use of CBT techniques to treat of kleptomania, with the application of psychological analysis theory techniques.

Used of the clinical interview, thematic apperception test (TAT) and neuroticism trait from big five personality traits. With these measurements was determined causes and level of the disorder, in addition behavior motivated and neuroticism trait.

Through the application of techniques and strategies of CBT and psychological analysis                    theory techniques the patient was treated for kleptomania symptoms and neuroticism trait (anxiety, anger, hostility, depression, consciousness-self, impulsiveness, stress and vulnerability). After treatment, the patient regained the ability to self-control, control of negative thoughts, and emotional stability.

The study recommends for avoid harsh punishment, the Importance of using the right methods of education with children and adolescents, especially the child talented. In addition to the importance of dealing with the kleptomania as a disease and not a crime. With the possibility using of projective tests and some psychological analysis techniques with CBT.

Open Access Original Research Article

Socio-demographic and Clinical Correlates of Community Reintegration of Stroke Survivors in Nigeria

Muhammad Usman Ali, Auwal Yahaya Garba, Adewale Luqman Oyeyemi, Mamman Ali Masta, Fatima Kachallah Gujba, Ali Alhaji Modu

International Neuropsychiatric Disease Journal, Page 1-7
DOI: 10.9734/indj/2020/v14i330128

Background: Low level of community reintegration among stroke survivors is a major obstacle to rehabilitation services post discharge from acute care. Few studies have assessed the impact of community reintegration on stroke survivors in Nigeria. This study investigates community reintegration and associated factors among stroke survivors in Maiduguri, Nigeria.

Methodology: Purposive sampling technique was used to recruit 55 stroke survivors attending rehabilitation services from two public hospitals in Maiduguri. Community reintegration was assessed with the Reintegration to Normal Living Index (RNLI) questionnaire, while information on sociodemographics (e.g., age group, gender, employment status, educational status) and clinical characteristics (e.g., post stroke duration, types of stroke, side of affectation) was obtained using the data form. Logistic regression analyses with odd ratios were used to test the associations between community reintegration and sociodemographic and clinical characteristics.

Results: The mean age and post stroke duration of the participants were 44.69±13.06 years and 17.25±24.90 months respectively. The participants’ community reintegration scores showed that 60%, 38.2% and 1.8% have no integration, mild to moderate reintegration and complete reintegration respectively. The results indicated that stroke survivors with a stroke duration greater than 8 months (OR=3.32, C.I=1.08-10.27) and those with haemorrhagic stroke (OR=4.67, C.I=1.05-20.66) were more likely to be reintegrated into the community than their counterparts with 6-8 months post stroke duration and ischaemic stroke, respectively. There was significant association between community reintegration and sociodemographic characteristics such as post stroke duration and type of stroke.

Conclusions: Rehabilitation strategies should focus on clinical characteristics of the stroke survivors when planning and delivering effective community reintegration interventions.

Open Access Original Research Article

Psychological Distress among Residents in Nigeria during the COVID-19 Pandemic

Chisom Adaobi Nri-Ezedi, Chioma Phyllis Nnamani, Nonye Ijeoma Ezeh, Chioma Okechukwu, Oluwatoyin Fasesan, Thomas Obiajulu Ulasi

International Neuropsychiatric Disease Journal, Page 8-21
DOI: 10.9734/indj/2020/v14i330129

Background: During an epidemic, an associated rise in mental health concerns is usually observed. The impact of the ongoing COVID-19 pandemic and lockdown on mental health of adults residing in Nigeria is unknown. The current study attempts to determine the prevalence of psychological distress among adult residents in Nigeria and explore any potential risk factors.

Methodology: An online survey developed with Google form was distributed to willing respondents using social media platforms between the time period of 24th of April to 30th of May 2020. Kessler psychological distress scale was used to assess for prevalence of mental health morbidity.

Results: Overall, 815 adults responded to the survey, of which 344 (42.2%) were males and 471 (57.8%) females with a Male: Female ratio of 1:1.4. Overall, the top 3 sources of information on facts concerning COVID-19 were television (28.1%), WhatsApp (16.5%) and health care providers (14.3%), while the least source of information was the Nigerian Center for Disease Control (NCDC) (0.8%). 47.3% of the respondents had psychological distress: medium risk (41.4%) and high risk (5.9%). Significant predictors include age, occupation, income, working status, and perception of how likely the respondent believe that he or she can be infected with the disease.

Conclusion: A high prevalence of psychological distress was detected among adults living in Nigeria. This calls for an urgent review of the existing national protocol on the management of COVID-19 to include strategies and programs that will promptly detect and address the mental health needs of at-risk populations.

Open Access Original Research Article

Sodium Valproate versus Propranolol in Chronic Migraine Prophylaxis

Hossam Egila, Zeinab El-Mahdy, Ahmed Azab, Mohammad Abu-Hegazy, Ayman Abdel-Naby

International Neuropsychiatric Disease Journal, Page 22-30
DOI: 10.9734/indj/2020/v14i330130

Background: There is a need for effective, well tolerated and affordable drug for chronic migraine prophylaxis in low socioeconomic countries.

Objective: To study the efficacy and safety of propranolol and sodium valproate (a food and drug administration approved and widely used treatment for prevention of migraine) as a prophylactic treatment in chronic migraine (CM) patients and to compare their efficacy and safety to each other.

Methods: In this single center, open labeled clinical trial, 40 patients with CM were subdivided into two group: group 1 (n=20) treated with propranolol and group 2 (n=20) treated with sodium valproate. Patients maintained headache diaries over a 1-month baseline period and a 6- month active study period. The evaluation of the treatment was done after 3 and 6 months of the initiation of the treatment. The efficacy measures were evaluation of monthly attacks frequency and attacks severity using VAS of pain (visual analogue scale. Disability and impact of migraine were evaluated using Migraine assessment disability scale (MIDAS) and Headache Impact Test (HIT-6). Throughout the study, patients were monitored for any symptoms or signs of adverse effects.

Results: Of 40 patients participated in this study (mean age, 33.48; females 72.5%). At the 6th month, the study was completed by 27 patients (propranolol; n=14 and sodium valproate; n=13). Between 55 and 62% of both groups reported more than 50% reduction in monthly attacks frequency. In both groups, there was significant reduction of VAS of pain scores. Both groups showed significant improvement of HIT-6 and MIDAS scores. Before the start of treatment, 85% to 100% of patients in both groups had severe MIDAS and HIT-6 scores. At the end of the study, only 35.7% of propranolol group and 30.8 of sodium valproate group showed severe MIDAS scores and 50% of propranolol group and 40% of sodium valproate group reported severe HIT-6 scores. 55% (n=11) of patients in propranolol reported AEs related to treatment compared to 75% (n=15) in the sodium valproate group. A higher proportion of patients discontinued the treatment because of AEs in Na valproate group compared to sodium valproate group with no statistically significant difference in between (20% vs. 5%, respectively).

Conclusions: Propranolol and sodium valproate demonstrated similar efficacy and tolerability in the prophylactic treatment of CM.

Open Access Original Research Article

Pathways to Care for Children with Mental Disorders and Epilepsy Attending Specialist Clinics in Nigeria

Tolulope Bella – Awusah, Adeola Adebayo, Ikeoluwa Lagunju, Olayinka Omigbodun

International Neuropsychiatric Disease Journal, Page 31-40
DOI: 10.9734/indj/2020/v14i330131

Aims: This study set out to identify and compare the pathways to care for children and adolescents presenting at child psychiatry and paediatric neurology clinics in South West Nigeria.

Study Design: This was a comparative cross sectional study.

Place and Duration of Study: Departments of Child and Adolescent Psychiatry and Paediatrics, University College Hospital Ibadan, Nigeria between February and May 2017.

Methodology: A sociodemographic questionnaire and the World Health Organization’s (WHO) pathway encounter form were used to assess 114 participants (57 in each group) recruited sequentially into the study. Kaplan meier survival analysis was used to compare time to seeking orthodox and specialist care between the two groups, and Atlas Ti software was used to analyse qualitative responses about barriers to accessing care. 

Results: There were slightly more males than females in both groups, and the mean age of participants was 9.87 years (SD =5.52). Participants in the paediatric neurology group were significantly more likely to access orthodox care at their first level of contact than their child psychiatry counterparts {41 (71.93%) vs. 18 (31.58%); P.<0.001}.  There were significant differences in the median survival time to accessing orthodox medical care between the two groups: {paediatric neurology 8 weeks (IQR =23.79) vs. child psychiatry 192 weeks (IQR =80; P < 0.001}. There was however no siginificant difference in median survival time to specialist care between the two groups. Lack of finances, frequently having to take time off work, and long distances to the hospital were the major barriers to accessing orthodox medical care in both groups.

Conclusions: Our findings suggest a need for continous advocacy to promote better access to orthodox healthcare for youths with psychiatric and neurological disorders in the developing world context.