Aims. War and conflict are known to adversely affect mental health, although their effects on risk symptoms for psychosis development in youth in various parts of the world are unclear. The Rwandan genocide of 1994 and Civil War had widespread effects on the population. Despite this, there has been no significant research on psychosis risk in Rwanda. Our goal in the present study was to investigate the potential effects of genocide and war in two ways: by comparing Rwandan youth born before and after the genocide; and by comparing Rwandan and Kenyan adolescents of similar age.Methods. A total of 2255 Rwandan students and 2800 Kenyan students were administered the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen. Prevalence, frequency and functional impairment related to affective and psychosis-risk symptoms were compared across groups using univariate and multivariate statistics.Results. Rwandan students born before the end of the genocide and war in 1994 experienced higher psychotic and affective symptom load ( p's < 0.001) with more functional impairment compared with younger Rwandans. 5.35% of older Rwandan students met threshold for clinical high-risk of psychosis by the WERCAP Screen compared with 3.19% of younger Rwandans (χ 2 = 5.36; p = 0.02). Symptom severity comparisons showed significant ( p < 0.001) group effects between Rwandan and Kenyan secondary school students on affective and psychotic symptom domains with Rwandans having higher symptom burden compared with Kenyans. Rwandan female students also had higher rates of psychotic symptoms compared with their male counterparts -a unique finding not observed in the Kenyan sample.Conclusions. These results suggest extreme conflict and disruption to country from genocide and war can influence the presence and severity of psychopathology in youth decades after initial traumatic events.

Background The world is dealing with a significant socio-economic burden that must be addressed to secure a favourable future.To figure out this problem, there is an urgent need of healthy and well educated adult population to participate effectively in global economy.Indeed, childhood experiences may affect adult health outcome.Responsive caregiving during childhood is associated with good physical and mental health.On the other hand,a strong link was established between Adverse Childhood Experiences (ACEs) and poor adult physical and mental health outcomes.This study assessed the prevalence of ACEs among adult patients with mental disorders admitted to the post-crisis wards at Caraes Ndera Neuropsychiatric Hospital in Kigali, Rwanda. Methodology : This research was developed as a descriptive cross-sectional study that involved a total of 122 patients aged 18 to 64 years.A convenience sampling was used to collect data using the the Adverse Childhood Experiences International Questionnaire (ACE-IQ). Data was analyzed in terms of frequencies and percentages using the Statistical Package for the Social Sciences (SPSS 21.0). Results Initially, 159 participants were invited to join the study, 122 (77%) met the inclusion criteria and voluntarily consented to participate. Of the 122 participants, 43.4% were female, 61% were youth, 67.2% had primary school as the highest level of education and 29.5% did not work during the last 12 months. Having separated/divorced or deceased parents was the most frequent ACE item with 64.8% of participants responding affirmatively. Nearly all (98.4%) participants had at least one ACE and 77.9% had at least 4 ACEs. Conclusions This study on ACEs in Rwandan adults with mental disorders revealed that 98.4% had at least one ACE and almost 80% of the 122 participants had at least 4 ACEs.The findings indicate that there is a significant need to implement interventions necessary for the prevention of ACEs. Such interventions are necessary to mitigate negative effects of ACEs on child development, to increase children’s resiliency and to improve future adult physical and mental health outcomes.

Aims: This quantitative study investigated the attitudes toward people with mental illness among professionals working in Ndera neuropsychiatric hospital in Rwanda. The purpose of this study was to determine whether there are differences in attitudes between direct care providers and supportive professionals towards the people with mental illness. Methods: The Community Attitudes towards Mentally Ill (CAMI) scale (Dear & Taylor, 1982) was used. A total of 72 members of the staff, including 55 directly involved staff members and 17 support staff members, participated in the survey. Results: The mean score is 3.98 for authoritarianism, 3.75 for social restrictiveness, 3.88 for benevolence, and 3.87 for community mental health ideology attitudes subscales. There is no statistically significant difference between the two groups in their overall scale scores. However, directly involved staff members had a greater mean score on many individual items (P≥0.05). Demographic variables did not account for the variance within the two groups (P≥0.05). 87.27% of our respondents think that staff members, patients and family members can be involved in the decision making process and 70.59% appreciate that it is good to involve staff, patients and family relatives in this process. Negative attitudes towards people with mental illness admitted to Ndera neuropsychiatric hospital are also present, even though the majority of our respondents have favorable attitudes towards the people with mental illness. There is the need to explore the influence of staff attitudes on the delivery of high quality healthcare.

Background Depression is more prevalent in medically ill patients than in the general population. More is not known about depression rates in internal medicine outpatients consulting the teaching hospitals in Rwanda. Adults with medical diseases are more likely to develop depression, it is an often-unrecognized co-morbidity in this group, and it has a major impact on their function and disability. In the absence of studies in our region, we did this research in our country with interest in what factors might be associated with depressive symptoms. Methods The descriptive cross-sectional study was used to determine the prevalence of depression and associated factors among internal medicine outpatients of Kigali university teaching hospital (CHUK). The 9 items Patient Health Questionnaire (PHQ-9) instrument was used to screen depression symptoms among outpatients. The validated cut-off score of 10 for diagnosing depression was applied in this study. Patients’ clinical and socio-demographic characteristics were collected and analyzed for their relationship with depression. All patients who scored PHQ-9 above 10 were referred to CHUK mental health department for appropriate management. Results Three hundred patients were recruited, of whom 65.3%) were females and 51% had an age between 45 and 96 years. The overall prevalence of depression among outpatients in the internal medicine department of CHUK was 45.7%. Outpatients had 20.7%, 17%, and 10% for moderate, moderately severe, and severe depression, respectively. Age, educational status, and follow-up visits as current physical complaints were independently associated with depression (P < 0.05). As much as 22.7% of patients were presenting with Suicidal ideas. The study showed that low income was strongly associated with suicide ideation (P < 0.001). Regardless of age and gender, the prevalence of depression was higher among outpatients of internal medicine than the general population. Conclusions A holistic approach in the management of internal medicine outpatients should be implemented to facilitate the early detection and treatment of depression in general tertiary hospitals. Furthermore, intervention programs that address depression and suicide in adults are needed.