BackgroundIndividuals with schizophrenia in low- and middle-income countries and their caregivers face multiple barriers to care-seeking and continuous engagement with treatment services. Identifying specific barrier patterns would aid targeted interventions aimed at improving treatment access.AimThe aim of this study was to determine stigma- and non-stigma-related barriers to care-seeking among persons with schizophrenia in Nigeria.SettingThis study was conducted at the Outpatient Clinics of the Federal Neuro-Psychiatric Hospital, Benin City, Nigeria.MethodsA cross-sectional study of a dyad of persons with schizophrenia and caregivers (n = 161) attending outpatient services at a neuro-psychiatric hospital in Nigeria. Stigma- and non-stigma-related barriers were assessed using the 30-item Barriers to Access to Care Evaluation (BACE) scale.ResultsLack of insight, preference for alternative care, illness severity and financial constraints were common barriers to care-seeking among persons with schizophrenia. Females were significantly more likely to report greater overall treatment barrier (p < 0.01) and stigma-related barriers (p < 0.02).ConclusionThis study shows that attitudinal barriers impede care access and engagement among persons with schizophrenia in Nigeria.

Suicidality is common and is associated with HIV-related stigma.

Background: Undetected depression can result in a significant decline in productivity among the workforce in every system, the healthcare sector inclusive. It is vital to utilize brief screening tools to detect populations at risk of depression. The 5-item WHO Well-being Index (WHO-5) has been used as a screening measure for depression, but research on this is scarce in sub-Saharan Africa. This study aimed to determine the utility and validity of the WHO-5 in screening for depression in a population of doctors and nurses in Nigeria during the COVID-19 pandemic. Methods: A representative sample of medical doctors and nurses across Nigeria (n = 464), completed the 5-item World Health Organization Well-Being Index (WHO-5) and the 9-item Patient Health Questionnaire (PHQ-9). Results: The pattern of factors associated with cases of a positive depression screening was considerably similar for the WHO-5 and the PHQ-9. At a cut-off score of 50 for the WHO-5, the sensitivity and specificity values obtained were 0.857 and 0.851 respectively. Positive and negative predictive values were 0.404 and 0.981 respectively. ROC analysis of the WHO-5 against the PHQ-9 revealed that, at a cut-off of 50, the sensitivity of the WHO-5 was 0.857, 1-specificity was 0.152. The AUC was 0.918 (95% CI 0.884-0.953). Also, there was a strong, negative correlation between the WHO and the PHQ-9 scores (r = −0.590, p ≤ 0.0001). Conclusion: The WHO-5 well-being index has satisfactory validity as a screening tool for the detection of depression. It is also feasible for use in very busy settings, because of its brevity and ease of administration.

ObjectiveTo estimate the prevalence of depression and anxiety and identify associated risk factors in hospitalised persons with confirmed COVID-19 in Edo, Nigeria.DesignA multicentre cross-sectional survey.SettingPatients with COVID-19 hospitalised at the three government-designated treatment and isolation centres in Edo State, Nigeria.ParticipantsThe study was conducted from 15 April to 11 November 2020 among 489 patients with confirmed COVID-19 and in treatment and isolation centres in Edo State, Nigeria. The mean age of participants was 43.39 (SD=16.94) years. Male participants were 252 (51.5%) and female were 237 (48.5%).Main outcome measuresThe nine-item Patient Health Questionnaire for depression, (total score: 0–27, depression ≥10), Generalized Anxiety Disorder-7 for anxiety (total score: 0–21, anxiety ≥10), and social demographic and clinical characteristics for associated risk factors.ResultsOf the 489 participants, 49.1% and 38.0% had depressive and anxiety symptoms, respectively. The prevalence rates of depression, anxiety and combination of both were 16.2%, 12.9% and 9.0%, respectively. Moderate-severe symptoms of COVID-19, ≥14 days in isolation, worrying about the outcome of infection and stigma increased the risk of having depression and anxiety. Additionally, being separated/divorced increased the risk of having depression and having comorbidity increased the risk of having anxiety.ConclusionA substantial proportion of our participants experienced depression, anxiety and a combination of both especially in those who had the risk factors we identified. The findings underscore the need to address modifiable risk factors for psychiatric manifestations early in the course of the disease and integrate mental health interventions and psychosocial support into COVID-19 management guidelines.

Introduction: Psychological disorders in HIV/AIDS are well documented. However, studies enumerating its impact on medication adherence are scanty in developing countries. This study sought to determine the collective impact of mood and anxiety disorders on medication adherence among persons living with HIV/AIDS (PLWHA), receiving care at a secondary health care facility in Benin-City, Nigeria. Material and methods:A cross-sectional descriptive study of 410 PLWHA was conducted between April and August 2015. A semi-structured socio-demographic and clinical history study questionnaire, the 8-item Morisky medication adherence scale (MMAS-8) to determine medication adherence to highly active antiretroviral therapy (HAART), and the mini international neuropsychiatric interview (MINI) to diagnose mood and anxiety disorders were administered to participants.Results: One hundred and fifty-one participants (36.8%) were poorly adherent to their medications, with nearly 1 in 3 (31.5%) diagnosed with a mood or anxiety disorder. On bivariate analysis, poor medication adherence was significantly associated with low (< 200 cell/mm 3 ) CD4 cell count (crude OR = 3.23; 95% CI: 1.81-5.80; p < 0.001) and having a mood or anxiety disorder (crude OR = 17.89; 95% CI: 10.28-31.38; p < 0.001). The presence of a mood/anxiety disorder predicted poor adherence (AOR = 16.45; 95% CI: 9.69-27.92; p < 0.001) on multivariate analysis.Conclussions: Mood and anxiety disorders in PLWHA are common and are associated with poorer medication adherence. Further research is required to assess if screening and management of mood and anxiety disorders would improve medication adherence.