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Adewuya AO, Oladipo O, Ajomale T, Adewumi T, Momodu O, Olibamoyo O, Adesoji O, Adegbokun A, Adegbaju D. Epidemiology of depression in primary care: Findings from the Mental Health in Primary Care (MeHPriC) project, Lagos, Nigeria. Int J Psychiatry Med 2022; 57:6-20. [PMID: 33573444 DOI: 10.1177/0091217421996089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To estimate the rate and correlates of depression in primary care using data from the Mental Health in Primary Care (MeHPriC) project, Lagos, Nigeria. METHODS Adult attendees (n=44,238) of 57 primary care facilities were evaluated for depression using the Patient Health Questionnaire (PHQ-9). Apart from the socio-demographic details, information was also collected regarding the use of alcohol and other psychoactive substances, presence of chronic medical problems, level of functionality, and perceived social support. Anthropometrics measures (weight and height) and blood pressure were also recorded. RESULTS A total of 27,212 (61.5%) of the participants were females. There were 32,037 (72.4%) participants in the age group 25-60 years. The rate of major depression (PHQ-9 score 10 and above) was 15.0% (95% CI 14.6-15.3). The variables independently associated with depression include age 18-24 years (OR 1.69), female sex (OR 2.39), poor social support (OR 1.14), having at least one metabolic syndrome component (OR 1.57), significant alcohol use (OR 1.13) and functional disability (OR 1.38). CONCLUSION Our study showed that the rate of depression in primary care in Nigeria is high. Screening for all primary care attendees for depression will be an important step towards scaling up mental health services in Nigeria and other developing countries.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
| | - Olabisi Oladipo
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
| | - Tolu Ajomale
- Mental Health Desk Office, Lagos State Ministry of Health, Ikeja, Lagos
| | - Tomilola Adewumi
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
| | - Olufisayo Momodu
- Centre for Mental Health Research and Initiative, Ikeja, Lagos, Nigeria
- Health Services Commission, Lagos State Ministry of Health, Lagos, Nigeria
| | - Olushola Olibamoyo
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Olabanji Adesoji
- Health Services Commission, Lagos State Ministry of Health, Lagos, Nigeria
| | - Adedayo Adegbokun
- Health Services Commission, Lagos State Ministry of Health, Lagos, Nigeria
| | - Dapo Adegbaju
- Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria
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Descriptive Epidemiology of Alcohol Use in the Lagos State Mental Health Survey (LSMHS), Nigeria. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-020-00263-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Mansourian M, Khademi S, Marateb HR. A Comprehensive Review of Computer-Aided Diagnosis of Major Mental and Neurological Disorders and Suicide: A Biostatistical Perspective on Data Mining. Diagnostics (Basel) 2021; 11:393. [PMID: 33669114 PMCID: PMC7996506 DOI: 10.3390/diagnostics11030393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 02/07/2023] Open
Abstract
The World Health Organization (WHO) suggests that mental disorders, neurological disorders, and suicide are growing causes of morbidity. Depressive disorders, schizophrenia, bipolar disorder, Alzheimer's disease, and other dementias account for 1.84%, 0.60%, 0.33%, and 1.00% of total Disability Adjusted Life Years (DALYs). Furthermore, suicide, the 15th leading cause of death worldwide, could be linked to mental disorders. More than 68 computer-aided diagnosis (CAD) methods published in peer-reviewed journals from 2016 to 2021 were analyzed, among which 75% were published in the year 2018 or later. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was adopted to select the relevant studies. In addition to the gold standard, the sample size, neuroimaging techniques or biomarkers, validation frameworks, the classifiers, and the performance indices were analyzed. We further discussed how various performance indices are essential based on the biostatistical and data mining perspective. Moreover, critical information related to the Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines was analyzed. We discussed how balancing the dataset and not using external validation could hinder the generalization of the CAD methods. We provided the list of the critical issues to consider in such studies.
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Affiliation(s)
- Mahsa Mansourian
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran;
| | - Sadaf Khademi
- Biomedical Engineering Department, Faculty of Engineering, University of Isfahan, Isfahan 8174-67344, Iran;
| | - Hamid Reza Marateb
- Biomedical Engineering Department, Faculty of Engineering, University of Isfahan, Isfahan 8174-67344, Iran;
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Kaiser BN, Ticao C, Anoje C, Minto J, Boglosa J, Kohrt BA. Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria. Glob Ment Health (Camb) 2019; 6:e10. [PMID: 31258924 PMCID: PMC6582460 DOI: 10.1017/gmh.2019.8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/19/2019] [Accepted: 05/13/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The Boko Haram insurgency has brought turmoil and instability to Nigeria, generating a large number of internally displaced people and adding to the country's 17.5 million orphans and vulnerable children. Recently, steps have been taken to improve the mental healthcare infrastructure in Nigeria, including revamping national policies and initiating training of primary care providers in mental healthcare. In order for these efforts to succeed, they require means for community-based detection and linkage to care. A major gap preventing such efforts is the shortage of culturally appropriate, valid screening tools for identifying emotional and behavioral disorders among adolescents. In particular, studies have not conducted simultaneous validation of screening tools in multiple languages, to support screening and detection efforts in linguistically diverse populations. We aim to culturally adapt screening tools for emotional and behavioral disorders for use among adolescents in Nigeria, in order to facilitate future validation studies. METHODS We used a rigorous mixed-method process to culturally adapt the Depression Self Rating Scale, Child PTSD Symptom Scale, and Disruptive Behavior Disorders Rating Scale. We employed expert translations, focus group discussions (N = 24), and piloting with cognitive interviewing (N = 24) to achieve semantic, content, technical, and criterion equivalence of screening tool items. RESULTS We identified and adapted items that were conceptually difficult for adolescents to understand, conceptually non-equivalent across languages, considered unacceptable to discuss, or stigmatizing. Findings regarding problematic items largely align with existing literature regarding cross-cultural adaptation. CONCLUSIONS Culturally adapting screening tools represents a vital first step toward improving community case detection.
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Affiliation(s)
- B. N. Kaiser
- Department of Anthropology, University of California San Diego, La Jolla, CA, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | | | - C. Anoje
- Catholic Relief Services, Abuja, Nigeria
| | | | | | - B. A. Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
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Adewuya AO, Coker OA, Atilola O, Ola BA, Zachariah MP, Adewumi T, Olugbile O, Fasawe A, Idris O. Gender difference in the point prevalence, symptoms, comorbidity, and correlates of depression: findings from the Lagos State Mental Health Survey (LSMHS), Nigeria. Arch Womens Ment Health 2018; 21:591-599. [PMID: 29594370 DOI: 10.1007/s00737-018-0839-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 03/22/2018] [Indexed: 01/06/2023]
Abstract
It is still unclear whether the gender difference in the rate of depression cuts across cultures or is specific to some depressive symptoms. This study evaluated the gender difference in current prevalence, symptoms, comorbidity, and correlates of depression in Lagos, Nigeria. A total of 11,246 adult participants (6525 females and 4712 males) in a face-to-face household survey were assessed for symptoms of depression. They were also assessed for symptoms of anxiety, somatic symptoms, alcohol and substance use disorders, and disability. The difference between the point prevalence for symptoms of depression in females (6.3%, s.e 0.3) and males (4.4%, s.e 0.3) was significant (OR 1.28, 95% CI 1.14-1.59). Compared to males, females had significantly higher rates for anhedonia (OR 1.20), hypersomnia (OR 2.15), fatigue (OR 1.49), guilt/worthless feeling (OR 1.41), poor concentration (OR 1.32), psychomotor retardation (OR 1.51), and suicidal ideation (OR 1.32). However, poor appetite (OR 0.69) and comorbidity with alcohol use (OR 0.25) was significantly lower in females compared to males. The significantly higher rates for depression in females were only restricted to below 45 years and higher socioeconomic status. Our study further contributed to the growing literature suggesting that the gender differences in rates of depression not only cut across many cultures, but most pronounced with atypical symptoms, not affected by recall bias and seems to disappear with increasing age. These need to be considered when formulating mental health policies for equitable and acceptable health services.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria. .,Centre for Mental Health Research & Initiative, Ikeja, Lagos, Nigeria.
| | - Olurotimi A Coker
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Olayinka Atilola
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Bolanle A Ola
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Mathew P Zachariah
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Tomilola Adewumi
- Centre for Mental Health Research & Initiative, Ikeja, Lagos, Nigeria
| | | | | | - Olajide Idris
- Lagos State Ministry of Health, Alausa, Ikeja, Lagos, Nigeria
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Adewuya AO, Atilola O, Ola BA, Coker OA, Zachariah MP, Olugbile O, Fasawe A, Idris O. Current prevalence, comorbidity and associated factors for symptoms of depression and generalised anxiety in the Lagos State Mental Health Survey (LSMHS), Nigeria. Compr Psychiatry 2018; 81:60-65. [PMID: 29268153 DOI: 10.1016/j.comppsych.2017.11.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 10/30/2017] [Accepted: 11/23/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Depression and anxiety are very prevalent, highly co-morbid, burdensome with huge treatment gaps in low and middle-income countries (LMICs). This study aimed to estimate the current prevalence of symptoms of depression and generalised anxiety, examine co-morbid conditions and associated sociodemographic factors in Lagos state, Nigeria. METHODS A face to face household survey completed by 11,246 adult participants (age 18-75years). Clinically significant symptoms of depression, generalised anxiety and somatic symptoms were assessed using the specific modules of the Patient Health Questionnaire (PHQ) respectively. Alcohol use, substance use and disability were assessed with the Alcohol Use Disorders Identification Test-short form (AUDIT-C), the Mini International Neuropsychiatric Interview (M.I.N.I) and the WHO Disability Assessment Schedule (WHODAS 2.0) respectively. RESULTS The mean age was 36.75 (sd 12.3) years and there were 6525 (58.0%) females. The weighted current prevalence of symptoms of depression, generalised anxiety and combined depression/generalised anxiety were 5.5% (se 0.3), 3.5% (se 0.2) and 1.2% (se 0.1) respectively. About 20.9% of all cases of depressive symptoms have co-morbidity with symptoms of generalised anxiety. Symptoms of depression and generalised anxiety had high co-morbidity with somatic symptoms, alcohol use problems and disability but not substance use disorders. Being female, not married (especially separated/divorced or widowed) and unemployment were significantly associated with presence of either symptoms of depression or generalised anxiety. CONCLUSION Our findings suggest that despite the popularity of cross-national surveys, there is need for individual countries and states to generate complimentary local data to plan effective local response to close the huge treatment gap for common mental disorders.
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Affiliation(s)
- Abiodun O Adewuya
- Lagos State University College of Medicine, Ikeja, Lagos, Nigeria; Centre for Mental Health Research & Initiative, Ikeja, Lagos, Nigeria.
| | - Olayinka Atilola
- Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Bolanle A Ola
- Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | | | | | | | | | - Olajide Idris
- Lagos State Ministry of Health, Alausa, Ikeja, Lagos, Nigeria
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Muhammed A, Dalhat MM, Joseph BO, Ahmed A, Nguku P, Poggensee G, Adeiza M, Yahya GI, Hamza M, Habib ZG, Oladimeji AM, Nasidi A, Balla A, Nashabaru I, Sani-Gwarzo N, Yakasai AM, Difa JA, Sheikh TL, Habib AG. Predictors of depression among patients receiving treatment for snakebite in General Hospital, Kaltungo, Gombe State, Nigeria: August 2015. Int J Ment Health Syst 2017; 11:26. [PMID: 28413440 PMCID: PMC5390352 DOI: 10.1186/s13033-017-0132-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 03/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Snakebite though neglected, affects 5 million people yearly. More neglected is the psychological effect of envenomation. We determined prevalence and pattern of depression among patients admitted into snakebite wards of Kaltungo General Hospital Nigeria, and percentage recognized by clinicians. We also assessed for factors associated with depression. METHODS In a descriptive hospital based study, we used Patient Health questionnaire (PHQ-9) to make diagnosis of depression among the patients. We reviewed patients' clinical records to determine clinicians' recognition of depression. RESULTS Of 187 interviews analyzed, 47 (25%) had depression with none recognized by attending clinicians. Patients with snakebite complications (odd ratio [OR] 3.1, 95% CI 1.1-8.5), and previous history of snakebites (OR 2.7, 95% CI 1.1-6.1) were associated with mild depression. Worrying about family welfare (OR 31.5, 95% CI 6.5-152.9), financial loss (OR 14.6, 95% CI 1.8-121.5) and time loss (OR 14.6, 95% CI 1.8-121.5), past history of snakebites (OR 8.3, 95% CI 1.9-36.5) and lower income (Mean difference -25,069 [84 USD], 95% CI 35,509 [118 USD]-14,630 [49 USD]) were associated with severe depression. CONCLUSION A quarter of in-patients of snakebite wards of the general hospital had comorbid depression that went unrecognized. Independent predictors of depression such as past history of snakebite, worrying about relations and having snakebite complications could help clinicians anticipate depression among patients. We recommend training of clinicians in the hospital on recognition of common psychological disorders like depression.
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Affiliation(s)
- Abdulaziz Muhammed
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria.,Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
| | - Mahmood M Dalhat
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Babalola O Joseph
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Abubakar Ahmed
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Gabriele Poggensee
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Mukthar Adeiza
- Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Garba I Yahya
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Muhammad Hamza
- Department of Medicine, Bayero University, Kano, Nigeria
| | - Zaiyad G Habib
- Department of Medicine, University of Abuja Teaching Hospital, Abuja, Nigeria
| | | | | | - Abubakar Balla
- Kaltungo General Hospital, Kaltungo, Gombe State Nigeria
| | | | - Nasir Sani-Gwarzo
- Port Health Services, Department of Public Health, Federal Ministry of Health, Abuja, Nigeria
| | - Ahmad M Yakasai
- Public Health and Diagnostic Institute, College of Medical Sciences, Northwest University, Kano, Nigeria
| | | | - Taiwo Lateef Sheikh
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
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Amoran O, Ogunsemi O, Lasebikan V. Assessment of mental disorders using the patient health questionnaire as a general screening tool in western Nigeria: A community-based study. J Neurosci Rural Pract 2012; 3:6-11. [PMID: 22346182 PMCID: PMC3271619 DOI: 10.4103/0976-3147.91922] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: Screening at the community level will provide keys to promoting health and preventing diseases at the community level and serve as the fulcrum for timely detection and intervention. This study aims to assess the prevalence and nature of mental disorder among the general population using the patient health questionnaire (PHQ). It also compares the use of PHQ and GHQ as general screening tools for mental disorders. Materials and Methods: This community-based study is cross sectional in design. Multistage sampling technique was used to obtain a representative sample of the communities. The PHQ and GHQ-12 questionnaires were concurrently administered by health care workers that were nondoctors to screen for psychiatric symptoms. Results: A total of 758 participants took part in the study, 496 (65.4%) of the subjects had a form of psychopathology or the other using PHQ and 143 (18.9%) using GHQ questionnaire (χ2 = 20.92, P = 0.000). Three hundred and thirty one subjects (43.7%) met the criteria for Somatoform disorder but 6.0% ever treated at PHC, 269 (35.5%) for depression and 4.8% ever treated, 127 (16.8%) for panic disorder and 5.5% ever treated, while 165 (21.8%) for general anxiety and 4.8% ever treated. Predictors of psychopathology were individuals who were singles (OR = 0.64, CI = 0.49–0.93) concerns about their health (OR = 3.06, CI = 2.06–4.56), worried about finance (OR = 1.84, CI = 1.27–2.67), worried about family life (OR = 2.68, CI = 1.61–4.72), and stressed at work (OR = 1.16, CI = 1.06–1.28). Conclusion: There is a high prevalence of psychopathology at the community level in this African population and few had ever been treated. PHQ as a general screening tool has a higher false-positive value compared to GHQ when used by nondoctors. PHQ should be used as an instrument to screen for specific mental disorders rather than a general screening tool for psychiatric morbidity at the community level.
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Affiliation(s)
- Oe Amoran
- Department of Community Medicine and Primary Care, College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
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Abiodun OA, Tunde-Ayinmode MF, Adegunloye OA, Ayinmode BA, Sulyman D, Unaogu NN, Saliu RO, Sajo S, Salami RA, Jimba MK, Agbabiaka T. Psychiatric morbidity in mothers of children attending primary care facility in Ilorin, Nigeria: drawing attention to those affected concurrently with their children. Gen Hosp Psychiatry 2011; 33:537-42. [PMID: 21958444 DOI: 10.1016/j.genhosppsych.2011.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 08/13/2011] [Accepted: 08/15/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To determine the prevalence of psychiatric morbidity among mothers of children attending a primary care clinic in University of Ilorin Teaching Hospital as precursor to developing an intervention programme. METHOD WThree hundred fifty mothers of children aged 7-14 years were screened with the 12-item General Health Questionnaire for psychiatric morbidity. As part of the larger study, their children were screened for psychiatric disorders with the parents' version of the Child Behaviour Questionnaire, and a subsample of 157 mother/child dyad had second-stage interview with the children's version of the Schedule for Affective Disorders and Schizophrenia to determine psychiatric morbidity in these children. RESULTS Twenty-eight out of 350 mothers (8%) had probable psychiatric morbidity. Mothers with psychiatric morbidity were significantly more likely to have children with Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition psychiatric diagnosis (8 of 28, P=0.011), experience parenting difficulties with some of their children (13 of 28, P=0.000) and have poor husband support for the care of their children. CONCLUSION The presence of psychiatric morbidity in mothers may require that other members of the family especially the children be screened for psychiatric disorders particularly when there are parenting difficulties and poor spousal support; in this way primary prevention or control can effectively be carried out.
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Affiliation(s)
- Olatunji Alao Abiodun
- Department of Behavioural Sciences, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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