The sociocultural conceptualisations of schizophrenia and patterns of help seeking in south-east Nigeria

Socioculturally influenced interpretations of mental illness play decisive roles on the time and choice of treatment. These often result in significant delays before patients present at the psychiatric services, with consequent worsening of the prognosis. The aim was to assess the association between sociocultural factors, choice of treatment and treatment delay among patients with schizophrenia. A cross-sectional study of 360 patients with schizophrenia, without previous contact with any statutory psychiatric services, was done. Of this, 75.8% of the participants had visited traditional/faith healers as the first treatment option and have attributed schizophrenia to magico-supernatural causation, despite 70.0% of the participants being educated, while 24.2% of them believed in the natural causation of the illness and presented early to psychiatric hospital. There is a need for community-based psychiatric services that would have mental health education as one of their core mandates; and collaborations with traditional and faith-based healers aimed to reduce delay in their facilities.     

Missed post-hospitalisation clinic appointment in a psychiatric hospital in Southeast Nigeria

ABSTRACT

Patients who have been attended to at psychiatric institutions sometimes fail to keep their scheduled appointments. This study was designed to assess the extent and determinants of missed first clinic appointments among recently discharged patients with schizophrenia. A total of 311 inpatients with a diagnosis of schizophrenia were participated in the study. The diagnosis of schizophrenia was confirmed using Munich version of the Composite International Diagnostic Interview. Socio-demographic and clinical data were collected using the socio-demographic questionnaire while analysis was done using SPSS (version 16). The rate of missed first outpatient appointment was found to be 25.7%. Missed appointment was associated with male gender, state of origin outside the study site, long distance from hospital to place of abode, longer appointment duration and illness severity at discharge. The findings in this study support the need for the introduction of community psychiatric services to improve patient access to services in Nigeria.     

No sex differences in spatial location memory for abstract designs

Previous research has demonstrated a female advantage, albeit imperfectly, on tests of object location memory where object identity information is readily available. However, spatial and visual elements are often confounded in the experimental tasks used. Here spatial and visual memory performance was compared in 30 men and 30 women by presenting 12 abstract designs in a spatial array for recall and recognition (visual memory) and spatial location ("object" location memory). Object location memory was measured via a sensitive absolute displacement score defined as the distance in mms between the position assigned to the object during recall and the actual position it originally occupied. There were no sex differences in either the visual or spatial location tests. Controlling for age and estimated IQ scores made no impact on the results. These data suggest an absence of a sex difference in purely visual and spatial aspects of object location memory.