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Biomedical subjects

O Gureje

Publications and source records attributed to O Gureje.

At least 55 records · Page 3Linked to original sources
PubMed1995

Prevalence of Alzheimer's disease and dementia in two communities: Nigerian Africans and African Americans.

OBJECTIVE: This article reports on a prevalence study of dementia and Alzheimer's disease among two groups of subjects with the same ethnic background but widely differing environments. METHOD: The study was conducted among residents aged 65 years and older in two communities: Yorubas (N = 2,494) living in Ibadan, Nigeria, and African Americans (N = 2,212 in the community and N = 106 in nursing homes) living in Indianapolis, Indiana. The study design consisted of a screening stage followed by a clinical assessment stage for selected subjects on the basis of their performance on the screening tests. RESULTS: The age-adjusted prevalence rates of dementia (2.29%) and Alzheimer's disease (1.41%) in the Ibadan sample were significantly lower than those in the Indianapolis sample, both in the community-dwelling subjects alone (4.82% and 3.69%, respectively) and in the combined nursing home and community samples (8.24% and 6.24%, respectively). The prevalence rates of dementia and Alzheimer's disease increased consistently with advancing age in both study groups. CONCLUSIONS: To the authors' knowledge, this is the first study, using the same research method at the two sites, to report significant differences in rates of dementia and Alzheimer's disease in two different communities with similar ethnic origins.

Black or African American↗
PubMed1995

Pathways to psychiatric care in Ibadan, Nigeria.

Pathways patients take to psychiatric care will reflect the nature of the services available and the popular beliefs about mental illness. Studying the pathways may help in the identification of sources of delay in the receipt of care and suggest possible improvements. By studying the pathways of 159 patients to a tertiary psychiatric service in Nigeria, we show that traditional and religious healers are consulted at some stage by many patients with mental illness. Such healers are the first carers to a large proportion of the patients. These patients are not different from those who consult orthodox medical practitioners either in demographic features, presenting complaints, or nearness to service. Patients who consult traditional healers first tended to arrive at a tertiary psychiatric service much later than those who consult other carers. Our observations suggest that attempts to incorporate traditional medical care into the health care system must seek to improve their referral skill.

Adult↗
PubMed1994

Early brain trauma and schizophrenia in Nigerian patients.

OBJECTIVE: A number of reports have suggested that early brain trauma, especially obstetric complications, may be associated with schizophrenia. This observation seems at variance with the similar rates of schizophrenia reported for advanced and developing countries when viewed against the high rate of perinatal morbidity in developing countries. Using patients with mania as comparison subjects, the authors investigated the association of early brain trauma with schizophrenia in adult life among Nigerian patients. METHOD: The manic (N = 12) and schizophrenic (N = 26) groups, both diagnosed according to the Research Diagnostic Criteria, were compared in respect to the prevalence of events commonly regarded as definite obstetric complications and the prevalence of childhood brain injury for which hospitalization was required. RESULTS: A history of early brain trauma was associated with an adult diagnosis of schizophrenia. Schizophrenic patients with a history of early brain trauma were more likely than those without early brain trauma to have shown poor scholastic performance in childhood. They also showed mixed cerebral laterality in adulthood. CONCLUSIONS: Early brain trauma may be a specific risk factor for the later development of schizophrenia. Patients with such a history may evidence other features of neurodevelopmental deviance.

Achievement↗
PubMed1994

Heritability of schizophrenia. A controlled family history investigation in Nigeria.

Thirty-six consecutively admitted patients with schizophrenia and 20 with mania were studied for the morbid risk of psychosis in their first-degree relatives. Using the family history method of ascertainment, the morbid risk for schizophrenia in the relatives of schizophrenic probands was 4.12% compared with 1.42% in the relatives of manic probands. While this difference was not statistically significant, that between the morbid risk for affective psychoses in the relatives of manic patients (7.81%) was significantly higher than for the relatives of schizophrenic patients (0%).

Adolescent↗
PubMed1994

Psychiatric disorders in a paediatric primary care clinic.

BACKGROUND: The proportion of children with psychiatric disorders treated in primary care is not known in most developing countries. METHOD: In a two-stage epidemiological study, 990 children aged between 7 and 14 years were screened with the parents' version of the Rutter scale. Of these, a stratified sample of 227 was interviewed jointly with their mothers, using the children's version of the Schedule for Affective Disorders and Schizophrenia (K-SADS). RESULTS: We obtained a weighted prevalence of 19.6 +/- 2.5% for the presence of one or more DSM-III-R disorders. Depressive disorders were present in 6.0%, anxiety-related disorders in 4.7%, and conduct disorders in 6.1%. CONCLUSION: Psychiatric disorders in children are common in primary care. Doctors working at this level of care need the skills to detect and treat them.

Adolescent↗
PubMed1993

Postnatal emotional disorders in Nigerian women. A study of antecedents and associations.

One hundred and sixty-two women were evaluated for psychiatric morbidity in the second trimester of pregnancy and also six to eight weeks postnatally. A sizeable proportion of the women also had a second prenatal assessment in their third trimester and in the lying-in ward shortly after giving birth. Assessments were conducted with the 28-item GHQ. This was initially validated using a subsample of 106 women, taken from the original group, who were interviewed with the PAS. Thirty per cent of the women were 'cases' at the first prenatal assessment, while only 14% were 'cases' six to eight weeks postnatally. Thus, even though there was an overlap between prenatal and postnatal morbidity, there was also substantial difference between the groups that were symptomatic at both periods. This observation was reinforced by the low correlation between the mean GHQ scores at both periods. Both prenatal and postnatal morbidities were associated with recent adverse life events, with the latter more likely to be associated with marital and family events. This observation is in support of the view that neurotic problems, prenatally or postnatally, are caused mainly by psychosocial factors.

Adult↗
PubMed1992

The validity of the 28-item General Health Questionnaire in a Nigerian antenatal clinic.

The 28-item General Health Questionnaire (GHQ-28) was validated against the Psychiatric Assessment Schedule (PAS) using data collected during a prospective study of psychiatric disorders associated with childbirth among 277 Nigerian women attending an antenatal clinic. Using the results of correlational analyses of the total scores on the GHQ and on the PAS and the traditional validity coefficients of sensitivity, specificity, and misclassification rate, the instrument was shown to be a valid tool for the detection of psychiatric morbidity in this population. With a sensitivity of 82% and a specificity of 85%, the revised scoring method devised by Goodchild and Duncan-Jones performed better in discriminating 'cases' from 'non-cases' than the conventional scoring method, which values respectively, of 75% and 83%. In a discriminant function analysis, only three of the four subscales of the instrument contributed to its discriminating power.

Adult↗
PubMed1992

Alcohol abuse and dependence in an urban primary care clinic in Nigeria.

A two-stage epidemiological survey was conducted in an urban walk-in clinic in Nigeria to detect, among other disorders, the prevalence of alcohol abuse and dependence using DMS-IIIR criteria. At the first stage, respondents were administered the 12-item General Health Questionnaire and the Alcohol Use Disorders Identification Test (AUDIT). A proportion of the respondents were selected for detailed interview at the second stage using the Composite International Diagnostic Interview (CIDI). An estimated 1.7% of this sample met the criteria for alcohol abuse or dependence. All the identified cases were males, thus giving an estimated prevalence of 5.2% in males. In this setting, the AUDIT performed poorly as a screening instrument. It has a sensitivity of 32% but a specificity of 93%. Apart from reasons relating to the low base rates of the disorders under investigation, cultural factors influencing the ways alcohol use are perceived may explain this poor performance.

Adolescent↗
PubMed1992

Somatization in primary care: pattern and correlates in a clinic in Nigeria.

During a study of mental disorder in a primary care clinic in Nigeria, 214 patients, selected on the basis of their scores on the General Health Questionnaire, were interviewed with the Composite International Diagnostic Interview, a structured clinical interview that allows for a systematic assessment of somatization symptoms. Only 1.1% of this clinical sample fulfilled the DSM-III-R criteria for somatization disorder, but 4.7% and 10.8% met the criteria for somatoform pain disorder and undifferentiated somatoform disorder, respectively. Age, gender and the presence of a DSM-III-R diagnosis of depression or dysthymia accounted for significant variability in the number of reported somatization symptoms. On factor analysis, a factor with close similarity to DSM-III-R somatization disorder was obtained. This factor is associated with the demographic features commonly found among patients with DSM-III-R somatization disorder.

Adult↗
PubMed1992

Prevalence of specific psychiatric disorders in an urban primary care setting.

In a two-stage epidemiological study to determine the prevalence and pattern of psychiatric morbidity in an urban primary care setting in Nigeria, the 12-item General Health Questionnaire (GHQ) was used to screen 787 clinic attenders while a modified version of a structured clinical interview designed for epidemiological surveys, the Composite International Diagnostic Interview (CIDI), was used to interview 214 subjects in the second stage. In order to improve case detection, selection for the second-stage was by stratified sampling in which patients were selected using a low score threshold and a revised scoring method devised to improve screening ability. A weighted prevalence for specific DSM-IIIR diagnoses of 27.8 per cent was obtained. Another 7.3 per cent of the clinic attenders suffered from non-specific disorders principally with mixed affective symptomatology. The association of demographic features to the disorders was examined; while a number of the associations followed previously reported trends, a few were unusual, possibly reflecting the cultural differences in the various study environments.

Adolescent↗
PubMed1991

Psychotropic drug use in an urban primary care clinic.

The prevalence and pattern of psychotropic drug use was investigated in an urban walk-in clinic in Nigeria during the course of a two-stage epidemiological survey. A total of 14.9% of the patients were using psychotropic drugs, with almost all the users taking anxiolytics. There was no significant sex difference in the prevalence of drug taking. Almost half of the users had been on the drug for over 12 months. Increasing age was associated with psychotropic drug taking in females while being married had a similar association in males. While increasing score on the GHQ-12 was associated with drug taking, over two-thirds of patients with DSM-IIIR disorders identified during the second-stage interview were not taking any psychotropic drug.

Adolescent↗
PubMed1991

Reliability and the factor structure of the Yoruba version of the 12-item General Health Questionnaire.

The reliability and the factor structure of the Yoruba translation of the General Health Questionnaire (GHQ) were investigated using data collected during a study of psychiatric morbidity among a sample of 787 primary care attendees. The instrument was shown to have a high degree of internal consistency. A two-factor solution provided the best description of the GHQ in this setting. Using subsamples selected on the basis of sex and age, these two factors were shown to be stable. Also, using data collected on a second-stage sample of 214 patients who were given a structured clinical interview, both factors discriminated "cases" from "non-cases" and one of the factors discriminated between depressed from non-depressed "cases".

Adult↗
PubMed1991

Gender and schizophrenia: age at onset and sociodemographic attributes.

A consecutive series of 214 patients (125 males, 89 females) who met the Research Diagnostic Criteria for schizophrenia were studied to determine gender differences in age at onset of the illness and sociodemographic attributes. The immediate family's first awareness of psychotic symptoms or signs and age at first presentation in hospital were used as indices of onset; male patients had a significantly earlier age of onset than females. By the time they were 30 years of age, 83% of male patients had already become ill and only 66% of females had done so. Significantly more females than males were married at the time of first contact with hospital. Married males did not differ from married females in age at onset of illness, suggesting that patients who marry may have late onset.

Adolescent↗
PubMed1991

Interictal psychopathology in epilepsy. Prevalence and pattern in a Nigerian clinic.

An unselected sample of 204 epileptic patients attending a neurological out-patient clinic in Abeokuta, Nigeria, was evaluated for psychiatric morbidity using the CIS. Thirty-seven percent emerged as psychiatric cases, almost a third of these being cases of psychosis. Patients with partial seizure of temporal lobe origin were the most psychiatrically impaired, while those with partial seizure of non-temporal lobe origin the least. These findings are broadly similar to those reported for epileptic populations in other studies. However, in spite of the relatively high prevalence of major psychiatric disorders among these patients, their impairments were more likely to remain 'hidden' and untreated than those in similar patients in developed countries.

Adolescent↗
PubMed1991

Puerperal psychiatric disorders in Nigerian women.

Forty-two cases of psychiatric disorders occurring within six-months of childbirth and seen over a 15-month period were studied retrospectively. The majority of the cases were less than 30 years old, married and primiparous. There was a preponderance of schizophrenic over other psychiatric syndromes. The onset of illness in the majority (71.4%) was after the first two weeks of post-partum. The implication of this for postnatal clinical assessment was discussed. There was no significant difference in the mean length of admission of the major diagnostic groups. The outcome was satisfactory in 76.2% of them.

Adolescent↗
PubMed1990

The GHQ-12 as a screening tool in a primary care setting.

The performance of the 12-item General Health Questionnaire (GHQ) was tested against a modified version of a structured diagnostic interview for making DSM III-R diagnoses, the Composite International Diagnostic Interview (CIDI), in a population of 787 primary care patients, 214 of whom were interviewed. The Yoruba versions of both instruments were found to be feasible in this setting and the inter-rater reliability of the CIDI was good. The GHQ-12 showed a sensitivity of 68% and a specificity of 70% when only cases meeting the criteria for specific DSM III-R disorders were considered. The sensitivity was better for certain individual disorders and the overall performance was marginally improved when scoring was made according to the revised method proposed by Goodchild and Duncan-Jones.

Adolescent↗
PubMed1989

The significance of subtyping tardive dyskinesia: a study of prevalence and associated factors.

The prevalence of tardive dyskinesia (TD) in 137 Nigerian psychiatric patients was 27%. There were no differences in the prevalence rate between patients with affective disorder and those with schizophrenia. There were also no significant differences between the sexes but a trend for the more severe forms of dyskinesia to be commoner in females was noticed. Demographic, clinical and treatment variables were investigated for association with TD and each of its two putative subsyndromes: orofacial and appendicular dyskinesias. Two cases of severe and persistent tardive dystonia, associated with orofacial TD, were seen in two young adults, one with relatively short exposure to neuroleptics. After initial univariate screening, multivariate statistical methods revealed that different factors were associated with each of the two subsyndromes. While length of hospitalization correlated significantly with orofacial dyskinesia, cumulative duration of exposure to high-potency neuroleptics and number of ECTs received were significantly associated with appendicular TD. Neither age nor sex correlated with either of the subsyndromes. The findings confirm and extend previous observations suggesting that these dyskinesias may involve different pathophysiological mechanisms.

Adult↗