DSpace Collection: Dissertations in CAMH

PREDICTORS OF DEPRESSION AMONG PRIVATE SECONDARY SCHOOL STUDENTS IN ZARIA, NORTHWEST NIGERIA

Sat, 01 Oct 2016 00:00:00 GMT

Title: PREDICTORS OF DEPRESSION AMONG PRIVATE SECONDARY SCHOOL STUDENTS IN ZARIA, NORTHWEST NIGERIA Authors: OLORUNFEMI, ARE AMOS Abstract: Background: Depression is one of the commonest mental health conditions affecting young people worldwide and is associated with a large illness burden. In the year 2000, depression was ranked as the 4th leading cause of disease burden globally as determined by Disability Adjusted Life Years (DALYs). It is projected that by the year 2020, it will become the 2nd most burdensome condition after cardiovascular diseases. The reported prevalence of clinically significant depression is 2% to 20 % among adolescents. There are a number of factors that are known to be predictors of adolescent depression like large family size, adolescent drinking, peer problems, poor self esteem, being a female and depression in parents. The specific objectives were to determine the prevalence of depression among school adolescents, to determine the predictors of depression among this group and to assess the relationship between depression and one risk factor (cyberbullying) and one protective factor (religiosity). Methodology: A cross- sectional descriptive study of 350 adolescents selected from two secondary schools in Zaria, Northwest Nigeria, through a multi- stage random sampling was carried out. First a Local Government Area (L.G.A) was randomly selected out of the four in the city. Then 2 private schools were selected from a list of 20 in the LGA. The actual selection of participants was by simple random sampling. Data was analysed using the Statistical Package for Social Sciences, version 20 (SPSS 20). Differences in Sociodemographic characteristics between those depressed and those not depressed were examined using the Chi square test. Multiple regression analysis was performed to determine the independent predictors of depression. The level of significance was set at 5% for all statistics. Results: The point prevalence of clinically significant depressions was 18.3%. The factors that were found to be independent predictors of depressive symptoms among school adolescents were coming from a polygamous family (p=0.029, AOR=2.38), and high level of father’s education (p=0.017, AOR=0.32). Cyberbullying via the mobile phone was significantly associated with depression (p=0.040) but was not an independent predictor. Conclusion: A high prevalence rate of depression was found among the school adolescents, to warrant appropriate school- based intervention programmes. The finding that polygamous family type is an independent predictor of depressive symptoms has particular relevance to Northern Nigeria where the practice of polygamy is rampant Description: A PROJECT SUBMITTED TO THE CENTRE FOR CHILD AND ADOLESCENT MENTAL HEALTH, IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN CHILD AND ADOLESCENT MENTAL HEALTH (MSC. CAMH) OF THE UNIVERSITY OF IBADAN, IBADAN

PREVALENCE AND CORRELATES OF COMMON MENTAL DISORDERS AMONG INTERNALLY DISPLACED ADOLESCENTS AND NON-DISPLACED ADOLESCENT STUDENTS IN MOGADISHU, SOMALIA

Thu, 01 Aug 2019 00:00:00 GMT

Title: PREVALENCE AND CORRELATES OF COMMON MENTAL DISORDERS AMONG INTERNALLY DISPLACED ADOLESCENTS AND NON-DISPLACED ADOLESCENT STUDENTS IN MOGADISHU, SOMALIA Authors: Mohamed, Yusuf Abdirisak Abstract: Background: After over two decades of dispute in Somalia, there is still not yet political stability. There are ongoing terrorist attacks in Mogadishu, Somalia which continues to negatively affect the population. In addition, hundreds of thousands of people have been displaced with inadequate access to basic health care, education and social services. The children and adolescents in this environment are exposed to traumatic events and violence. This exposure is said to be associated with depression, post-traumatic stress disorder and a greater risk of substance use. There is no existing data on the prevalence or pattern of common mental disorders among adolescents in IDPs camps in Mogadishu, Somalia. The study aims to compare the prevalence and correlates of common mental disorders among adolescents in IDP camps with adolescents living in the community in Mogadishu, Somalia. Methodology: A comparative cross sectional design was utilized for the study in four secondary schools and four IDP camps. Three hundred and twenty participants were recruited in the study (160 in-school living at home with parents and 160 in-IDP camp). The Multistage sampling technique was used to select the participants. Study instruments utilized were a socio-demographic questionnaire, Harvard Trauma Questionnaire, Rosenberg Self-Esteem Scale (RSES) and Patient Health Questionnaire (PHQ-9). Data were analyzed using the statistical package for social sciences version 24 (SPSS-24). Descriptive statistics such as proportions and percentages were used to present data. Chi-square were also used to test associations at p<0.05. Results: The prevalence of common mental disorders was higher among adolescents living in IDP camps with 51.9% and 28.8% for depression and PTSD respectively as compared to adolescents living in the community with their parents attending school with 28.8% and 8.8% for depression and PTSD respectively. The study found gender (p=0.026), age (p=0.034), perceived relationship with parents (p<0.0001) and exposure to traumatic events during childhood (p<0.0001) to be significantly associated with mental disorders. The study found a significant association between living in IDP camps (p<0.0001) and development of common mental disorders. Conclusion: The prevalence of common mental disorders was higher among adolescents living in IDP camps than among adolescents living in the community with their parents. It also found that factors such as exposure to traumatic events were significantly associated with development of mental health problems among the adolescents. Description: A RESEARCH PROJECT SUBMITTED TO THE CENTER FOR CHILD AND ADOLESCENT MENTAL HEALTH IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF THE DEGREE OF MASTER OF SCIENCE, CHILD & ADOLESCENT MENTAL HEALTH, UNIVERSITY OF IBADAN. NIGERIA.

ACADEMIC STRESS AND MENTAL HEALTH PROBLEMS AMONG IN-SCHOOL ADOLESCENTS IN IBADAN

Wed, 01 May 2019 00:00:00 GMT

Title: ACADEMIC STRESS AND MENTAL HEALTH PROBLEMS AMONG IN-SCHOOL ADOLESCENTS IN IBADAN Authors: UMOREN, EDET EUNICE Abstract: Background: Adolescence is a period of transition from the immaturity of childhood into the maturity of adulthood. During this period, adolescents undergo a process of physical, psychological, cognitive, social and emotional changes. As these transitions occur, adolescents are likely to face various challenges that may result in mental health problems. This makes Adolescents particularly vulnerable to the problems associated with academic stress such as class workload , need for perfection , worry over grades, parental pressure, and competition. Studies have established that, academic stress is associated with mental health problems of the adolescents. There is a paucity of studies on the relationship between academic stress and mental health problems among secondary school students in Nigeria. This study therefore aimed to determine the prevalence and correlates of academic stress and mental health problems among senior secondary school adolescents. Methodology: This was a cross sectional study in which six secondary schools were randomly selected from a list of all secondary schools in Akinyele, Local Government, Ibadan. A total of 366 senior secondary school students were randomly selected from the six schools. A socio-demographic questionnaire was used to obtain the students’ background information. The Educational Stress Scale for adolescents (ESSA) was used to assess academic stress, Beck Depression Inventory used to assess depression, Beck Anxiety Inventory was used to assess anxiety and Scale for suicidal Ideation was used to assess suicidal ideation. Results: There were 45.9% males and 54.1% females with age range between 11 to 19years, mean age was 15years SD = 1.77. Reported prevalence of academic stress was 45.1%. and reported prevalence of mental health problems showed depression 41.8%, anxiety 29% and suicidal ideation of 38.8% . Socio-demographic correlates of academic stress showed that adolescents in public secondary school were 2 times more likely (OR=2.33, 95% CI=1.3 - 4.1) (p<0.05) to report academic stress than adolescents in private secondary schools. Adolescents in SSS 2 class were 3 times more likely (OR= 3.15, 95% CI=1.8 - 5.5) (p<0.05) to report academic stress than adolescents in SSS 1 and SSS 3 classes. Female adolescents were 1.56 times more likely (OR= 1.56, 95% CI=0.4 - 0.9) (p<0.05) to report academic stress than male adolescents. Adolescents belonging to class of over 25 members were 2 times more likely (OR = 2.17, 95% CI=0.2 - 0.7) (p<0.05) to report academic stress than adolescents belonging to class of 0 - 25 members. Socio-demographic correlates of depression showed that adolescents belonging to polygamous families were 1.85 times more likely (OR =1.85, 95% CI=1.1 - 2.9) (p<0.05) to report depression than adolescents belonging to monogamous families. Adolescents belonging to class of over 25 members were 1.8 times more likely (OR = 1.80, 95% CI=1.1 - 2.8) (p<0.05) to report depression than adolescents belonging to class of 0 - 25 members. Socio-demographic correlates of anxiety showed that adolescents in private secondary schools were 2 times more likely (OR= 2.11, 95% CI=0.2 - 0.8) (p<0.05) to report anxiety than adolescents in public secondary schools. Adolescents in SSS 2 class were 2 times more likely (OR= 2.35, 95% CI=1.4 – 3.9) (p<0.05) to report anxiety than adolescents in SSS 1 and SSS 3 classes. Among the mental health problems, depression (χ2 = 6.907, p<.006) and anxiety (χ2 = 8.001, p<.003) were significantly associated with academic stress. Conclusions: The study revealed that a significant association exist between academic stress and mental health problems. It is recommended that a holistic approach be adopted to prevent academic stress. Treatment and counseling should be offered to vulnerable senior secondary school students, through continual appropriate screening and intervention programs in order to prevent mental health problems and improve their quality of life. Description: A Research Proposal submitted to the Centre for Child and Adolescent Mental Health (CCAMH), in partial fulfillment of the requirements for the Degree of Masters of Science in Child and Adolescent Mental Health (M.Sc. CAMH) of the University of Ibadan, Nigeria.

A RESEARCH PROJECT SUBMITTED TO THE CENTRE FOR CHILD AND ADOLESCENT MENTAL HEALTH IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN CHILD AND ADOLESCENT MENTAL HEALTH (M.Sc. CAMH) OF THE UNIVERSITY OF IBADAN

Sat, 01 Jun 2019 00:00:00 GMT

Title: A RESEARCH PROJECT SUBMITTED TO THE CENTRE FOR CHILD AND ADOLESCENT MENTAL HEALTH IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN CHILD AND ADOLESCENT MENTAL HEALTH (M.Sc. CAMH) OF THE UNIVERSITY OF IBADAN Authors: SIMBEE, GEMA PETER Abstract: Background: The global burden of child and adolescent mental disorders is well established to be high, and affecting 1 in every 5 children and adolescents. However, there is paucity of data on the magnitude of child and adolescent mental health problems in Tanzania, particularly at Mirembe Mental Health Hospital (MMHH), which is the only referral tertiary mental health facility in the country, and receives patients from all over Tanzania mainland. There is also little or no information about the pathways utilized by people whose children may require mental health care in Tanzania. Therefore, the purpose of the present study was to determine the magnitude and pattern of neuropsychiatric morbidity among children and young persons at MMHH; pathways used to access CAMHS; factors influencing such choices; and caregivers’ and health workers’ perceptions to CAMHS offered in Tanzania. Methodology: This was a descriptive, cross sectional, hospital based observational study, which was conducted at the CAMH clinic of MMHH, in Dodoma. It comprised of two groups of participants: a) 354 children/young persons aged 6-24 years as well as their caregivers attending the clinic, that were recruited consecutively; and b) 27 MMHH health workers, comprising of the CAMH clinic staff, and the hospital health management team, that were purposefuly sampled. Tools used in data collection were: Researcher designed Socio-demographic Questionnaire, WHO Modified Encounter Form, the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime version, DSM 5, 2016 (K SADS-PL DSM 5, 2016), the Children Global Assessment Scale (C-GAS), Modified Patients Assessment Care for Chronic Conditions (PACIC) and Modified Assessment of Chronic Illness Care for Mental Illness (ACIC). Data were analyzed using the IBM SPSS software for Windows Version 23. Descriptive statistics such as frequency and proportions and inferential statistics including Chi square and Fisher’s exact tests to test association between categorical variables; and t test to compare means were used. A significance level was set at 5%. Logistic regression analysis model was employed to determine the independent predictors of both choice of care pathways and delay in care seeking. Results: The children and young persons who participated in the study were aged 6 to 24 years, with a mean of 16.72 years (SD: ±5.584) years. Only 57 participants (16.1%) were aged 6-9 years. There were more males thans females 209 (59.0%). Three quarters were residents of Dodoma. The health workers comprised of 14 males and 13 females, with age range of 30 to 60 years, mean 43.19 years (SD ±9.564). They were of different health cadres. Epilepsy was the most prevalent condition (56.5%), followed by Intellectual Disability [ID] (17.5%), schizophrenia (16.4%), psychosis due to general medical condition [GMC] (13.6%) and depression (10.2%) as the top 5, most common conditions. There was also a high comorbidity rate in this study partcipants, with 45% having comorbidities and majority (89.0%) having 2-3 conditions. In addition, the disorders were found to have a specific age and gender distribution. It was shown that depression (p=0.003), bipolar disorders (p=0.012), schizophrenia (p<0.000), psychosis due to GMC (p=0.000), cerebral palsy [CP] (p<0.000), ID (p<0.000), Attention deficit hyperactivity disorder [ADHD] (p<0.000) and Autism spectrum disorder [ASD] (p<0.000) were age related. On the other hand, gender was associated with having schizophrenia (p=0.049), substance induced psychosis (p=0.004), epilepsy (p=0.009), CP (p=0.027), and cannabis use disorder (p=0.006). It was also found that schizophrenia (p=0.001), enuresis (p<0.000), encopresis (p=0.006), epilepsy (p=0.000), CP (p<0.000), ID (p<0.000), ADHD (p<0.000) and ASD (p<0.000) were associated with more functional impairment compared with other conditions. Parents were the main care initiators (89.0%). Forty seven percent used the non-medical care pathways in their first contact of care whereas 15.0% went directly to MMHH. Predictors of choice of a non-medical pathway were: father’s and mother’s education being primary (AOR=0.27, p=0.032) and (AOR=3.25, p=0.032) respectively, belief that the cause of illness was high fever or other (AOR=0.01, p<0.000), caregivers reporting not knowing the cause of the child’s illness (AOR=0.01, p<0.000) and reporting worry/tension about the child’s condition (AOR= 3.55, p=0.022). Mean time for seeking care at MMHH since the onset of symptoms was 66.8 months, with 69.5% reporting having not sought care within a week of onset of symptoms. Factors that were independently associated with delay in care seeking were: being cared for by single parents (AOR=2.71, p=0.018), having normal functioning (AOR=2.59, p=0.010), belief that the cause of illness was high fever or other (AOR=0.50, p=0.031), and having epilepsy (AOR=0.24, p=0.000). Stigma (50.0%), long distance (42.4%), and financial constraints (34.5%) were found to be common barriers to care. With regards to patients’ and caregivers’ perceptions of CAMHS in Tanzania, the overall mean score was 1.83 (median 1.9, interquartile range 1.55) indicating poor support. Health workers’ perceptions about CAMHS offered at MMHH had an overall mean score of 1.9 with median of 1.8 and interquartile range of 0.3, indicating limited to basic support. Conclusion: The primary initiators of care were parents, and the first choice of care pathway for a large proportion of the population continues to be through non-medical services. This study provided evidence that neuropschiatric morbidity is high; and that generally CAMH services in Tanzania are poor, the population is unaware about available services, and are further hampered by financial and distance constraints. Thus, there is a high unmet need and huge treatment gap for children and young persons with neuropsychiatric problems. Concerted efforts aiming to promote public awareness and services utilization are urgently required; as well as effective integration of CAMHS into district and primary care clinics. Description: A RESEARCH PROJECT SUBMITTED TO THE CENTRE FOR CHILD AND ADOLESCENT MENTAL HEALTH IN PARTIAL FULFIlLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN CHILD AND ADOLESCENT MENTAL HEALTH (M.Sc. CAMH) OF THE UNIVERSITY OF IBADAN, NIGERIA.