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对尼日利亚东南部精神疾病和精神疾病复发的人口统计学、社会经济和临床变量进行分析。

An analysis of demographic, socio-economic and clinical variables for mental illness and mental illness relapse in south-east nigeria.

机构信息

Institute for Development Studies, Enugu Campus, University of Nigeria, Nsukka, Enugu State, Nigeria.

Department of Agricultural Economics, University of Nigeria, Nsukka, Enugu State, Nigeria.

出版信息

Sci Rep. 2024 Oct 4;14(1):23079. doi: 10.1038/s41598-024-74296-6.

Abstract

Mental health has come into the front burner of development challenges amid declining socio-economic outcomes, especially in developing countries. Insecurity, conflicts and extremely threatening events, which trigger mental disorders, are common in South-East Nigeria, with many military operations, unknown gunmen attacks and kidnapping leading to the cold-blood assassination and kidnap of dear ones. The study aimed to analyze the demographic, socio-economic and clinical variables for mental illness in South-East Nigeria. Consecutive sampling technique was used to obtain a three-year records of the cases of 380 index and 180 post-index points data of mental illness cases that met the inclusion criteria in a purposively selected public mental health hospital. Data were analyzed using both descriptive and inferential statistics, including frequency count, percentages, chi-square and multinomial logistic regression. Results showed that over a half (55.0%) of the patients were males, and 65.27% had post-primary education. The mean age of patients was 39.87 years. Slightly above half of the cases (55.26%) were single and 56.84% were unemployed. Schizophrenia (68.42%) topped the list of the cases. The rate of relapse was 52.1%, with males being in the majority (61.62%). About 61.62% of those who relapsed were unemployed, 9.60% were into business/trading, and 5.05% were professionals. Those with 5 years and above illness duration had a higher percentage of relapse (52.02%) as well as those with poor drug compliance (66.16%). The mean relapse age was 34.23 years. Educational status, employment status/social class, marital status, and age were socio-economic/clinical factors that associated strongly with relapse at p-value of 0.10. Patients with ≥ 5 and ≤ 3 years duration of illness were 1.17 times on the average more likely to have relapse than those with three or less than 3 years. Onset age for illness predicted 2.479 times more likelihood of relapse. Being employed and having more family support, as against being unskilled/unemployed and not having family support, reduce the likelihood of relapse by 1.110 times on the average. The study recommended policy formulation and implementation for protection against mental illness and mental healthcare provision and access; for tackling unemployment head-on; for improvement of the access to effective treatment of mental illness; and mass education, especially among unemployed, uneducated, singles, and under-35 years of age, to help reduce the high rate of relapse of mental illness in South-East Nigeria.

摘要

心理健康在社会经济成果下降的情况下成为发展挑战的焦点,尤其是在发展中国家。在东南亚国家,不安全、冲突和极其威胁性的事件引发了精神障碍,这些事件很常见,许多军事行动、身份不明的枪手袭击和绑架导致亲人被冷血暗杀和绑架。本研究旨在分析东南亚精神疾病的人口统计学、社会经济和临床变量。采用连续抽样技术,从一家专门选择的公立精神卫生医院获得了符合纳入标准的 380 名索引病例和 180 名后索引点精神疾病病例的三年记录。使用描述性和推断性统计,包括频数计数、百分比、卡方和多项逻辑回归分析数据。结果显示,超过一半(55.0%)的患者为男性,65.27%接受过中学后教育。患者的平均年龄为 39.87 岁。略超过一半的病例(55.26%)为单身,56.84%失业。精神分裂症(68.42%)位居病例之首。复发率为 52.1%,男性居多(61.62%)。复发者中约有 61.62%失业,9.60%从事商业/贸易,5.05%为专业人士。患病 5 年及以上的患者复发率较高(52.02%),药物依从性差的患者(66.16%)也较高。平均复发年龄为 34.23 岁。教育程度、就业状况/社会阶层、婚姻状况和年龄是与复发密切相关的社会经济/临床因素,p 值为 0.10。患病时间≥5 年且≤3 年的患者平均复发风险增加 1.17 倍。发病年龄预测复发的可能性增加 2.479 倍。与非熟练/失业且没有家庭支持的人相比,就业和获得更多家庭支持可使复发的可能性平均降低 1.110 倍。该研究建议制定和实施政策,以保护人们免受精神疾病的影响,并提供和获取精神保健服务;积极解决失业问题;改善获得有效精神疾病治疗的机会;开展大众教育,特别是针对失业、未受教育、单身和 35 岁以下人群,以帮助降低东南亚精神疾病的高复发率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ed5/11452622/9229d514ac95/41598_2024_74296_Fig1_HTML.jpg

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