Department of Psychiatry, University of Nairobi, Nairobi, Kenya.
Africa Mental Health Research and Training Foundation, Mawensi Road, Off Elgon Road, Mawensi Garden, P.O. Box 48423-00100, Nairobi, Kenya.
Sci Rep. 2023 Dec 21;13(1):22889. doi: 10.1038/s41598-023-50192-3.
Little is known about the prevalence of Conduct Disorder (CD) and symptoms of CD in high risk psychosis persons at both clinical and community populations in LMICs and in particular Kenya. This study aimed to document (1) the prevalence of CD diagnosis and symptoms in youth who screened positive for psychosis and (2) the associated mental disorders and substance use in the same cohort in LMIC. The sample size was 536 students who had screened positive on the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) from a population of 9,742 high school, college and university students, but had not converted to a psychotic disorder. We collected data on socio-demographic characteristics and used the following tools: Economic indicators tool; the Diagnostic Interview Schedule (DIS) tool for DSM-5 diagnosis; World Health Organization (WHO) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Basic descriptive statistics, chi-square test, Fisher's exact test, Pearson correlation and Poisson regression were conducted. Five percent (5%) of the respondents met the criteria for DSM-5 CD. Indeterminate CD comprised 10.1%. Male gender, all substances except hallucinogens lifetime, obsessive compulsive disorder, psychosis, agoraphobia, social phobia, drug abuse/dependence, antisocial personality disorder, oppositional defiant disorder, suicidality, WERCAP screen for bipolar disorder and WERCAP screen for schizophrenia were significantly (p < 0.05) associated with CD. Deceitfulness or theft criteria symptoms showed that CD had no significant gender difference. Criteria symptoms in aggression to people and animals, destruction of property and serious violations of rules were more common among males. Our findings suggest the need to screen for and diagnose CD, mental disorders and substance use in high risk psychosis youths in Kenya. This will inform integrated management.
在中低收入国家（LMIC），尤其是肯尼亚，针对临床和社区高风险精神病患者中品行障碍（CD）的流行情况及其症状，人们知之甚少。本研究旨在记录：（1）在筛查阳性的青年人群中 CD 的诊断和症状流行情况；（2）在同一队列中与 CD 相关的精神障碍和物质使用情况。研究样本为 536 名在华盛顿早期识别中心情感和精神病（WERCAP）筛查中呈阳性的学生，他们来自 9742 名高中生、大学生和大学生群体，但尚未转化为精神病。我们收集了社会人口统计学特征的数据，并使用了以下工具：经济指标工具；用于 DSM-5 诊断的诊断访谈表（DIS）工具；世界卫生组织（WHO）酒精、吸烟和物质使用情况筛查测试（ASSIST）。进行了基本描述性统计、卡方检验、Fisher 确切检验、Pearson 相关和泊松回归分析。5%的受访者符合 DSM-5 CD 的标准。不确定 CD 占 10.1%。男性、所有物质（除致幻剂外）终生使用、强迫症、精神病、广场恐惧症、社交恐惧症、药物滥用/依赖、反社会人格障碍、对立违抗性障碍、自杀意念、WERCAP 双相情感障碍筛查和 WERCAP 精神分裂症筛查与 CD 显著相关（p < 0.05）。欺骗或偷窃标准症状表明 CD 无显著性别差异。在针对人和动物的攻击、破坏财产和严重违反规则的标准症状中，男性更为常见。我们的研究结果表明，有必要在肯尼亚对高风险精神病青年进行 CD、精神障碍和物质使用的筛查和诊断，这将为综合管理提供依据。
