The Association of Psychiatrists in Nigeria(APN)held her 38th Annual Scientific And General Meeting recently at the Lagos State University Teaching Hospital(LASUTH) with the above theme.The meeting was graced by seasoned Psychiatrists in Nigeria.It was another time more or less, to take stock of the state of affairs as it affects Psychiatric services and practice in Nigeria.
The Chief Medical Director of the host hospital, Dr Femi Olugbile delivered a paper with the theme as the topic i.e 'Organization of Mental Health Services in Nigeria.In his lecture,he commented on the need to boost the knowledge and skills of General practioners and family physicians as an important and first step towards bringing appropriate and effective treatment closer to Ngerian on Psychiatric problems.He further advocated the grouping of Mental illnesses as special category of sickness with a bid to facilitate the provision of free treatment for these category of patients.
Other very important highlights of his lecture include the fact that 1 in 5 roadside destitutes in Nigeria is due to psychosis or drug abuse.Furthermore,he shed light on the fact that the global burden of mental illnesses is such that it is near the top of list of global burden of diseases.Depression particularly causes more Disability Adjusted Life Years(DALYs) than most other illnesses known to man.He further declared that only 1 in 100 of Nigerians needing Psychiatric treatment seek for it in Nigeria.This is a feeler of the extent of awareness of mental illnesses and availability of Psychiatric services in Nigeria.Finally,it was pointed out that though psychotic cases tend to be very dramatic,the vaste majority of psychiatric cases tend to be subtle and invisible or unnoticeable.
It is hoped that the knowledge gained in this meeting is not going to be just for the sake of it,but is going to translate into the much needed education of the general populace about mental illnesses,as well as the organization of strong mental health advocacy groups.
Thursday, November 29, 2007
Good Samaritan Rehabilitation Home;an update.
I had earlier posted that the government of Plateau state is closing down the above named centre.I also asked what will happen to those patients in the place after the closure.Well the good news is that the state government is making effort to ensure that there is a ward for these folks at the Vom Christian Hospital where they are going to be managed for a period of about three months with all expenses of managing them being borne by the state government.It is hoped that by the end of this period,a good number of them would have made remarkable improvement as to be able to recollect their homes and relatives and effort will then be made to reunite them with their people.
You must agree with me that this is really nice on the part of the government.It shows a lot of commitment to service and the overall well-being and health of the people.However,after the expertion of these three month period,what happens.Although I have never been to the Good Samaritan Rehabilitation Home,but I believe(from what I heard about the story of that place)that it could still be put at better use by the government if only they will re-organize the place and run it in collaboration with the department of Psychiatry,Jos University Teaching Hospital.Surely the state government can also help in that regard to boost up Mental Health facilities and services present in the state given the overstretched nature of the facilities in JUTH.
So,while I commend the government of Plateau state for this decision in the short term,I am appealing for a long term decision of establishing a Rehabilitation Centre in the State and further boost up Psychiatry facilites in the state.
You must agree with me that this is really nice on the part of the government.It shows a lot of commitment to service and the overall well-being and health of the people.However,after the expertion of these three month period,what happens.Although I have never been to the Good Samaritan Rehabilitation Home,but I believe(from what I heard about the story of that place)that it could still be put at better use by the government if only they will re-organize the place and run it in collaboration with the department of Psychiatry,Jos University Teaching Hospital.Surely the state government can also help in that regard to boost up Mental Health facilities and services present in the state given the overstretched nature of the facilities in JUTH.
So,while I commend the government of Plateau state for this decision in the short term,I am appealing for a long term decision of establishing a Rehabilitation Centre in the State and further boost up Psychiatry facilites in the state.
Sunday, November 25, 2007
In support of the movement:The Fight Against Child Abuse.
I came across this blog entry recently and I could not just pass bye.I really wonder why someone would do such a thing?May God help us against such crimes against humanity.Please read on and lend support to the cause.
In our times of darkness, children are the ones who will brighten us up. No matter what ordeals we have to endure in our daily lives, we know that we can overcome them the moment we set eyes on children. Their innocence and purity in them will always give us a sense of peacefulness and calm that is beyond words. And it goes without saying that life would be meaningless without seeing them smile, hearing them laugh and cry, and feeling their small and flawlessly gentle hands that want to reach out to us.
Yet, there are some who show no empathy and sensitivity towards these beautiful souls. Worse still, they would dunk themselves into physical violence and cruelty towards the children without even thinking twice. Such acts can deem someone to be worse than an animal, because even an animal has compassion and love for its young.
What is going on with this world? Why must such horrid acts be carried out? Why do these people ever exist in this world?
Please take this time to read this special message from us, and show your utmost support and sympathy towards the family of the late Nurin Jazlin, who passed away tragically and brutally at the age of only eight. Little Nurin Jazlin’s body was discovered in a gym bag on 17th September, one month after she was abducted. Upon the discovery, she was seen to be in the most horrifying state ever. Her hair was short and curled up, when it was originally straight and long. Her body was pale and badly bruised from head to toe, and there were traces of foreign objects like brinjal and cucumber found in the virginal area of her body.
Parents of the deceased took a long time to acknowledge her death, but eventually did after all the thorough DNA tests had been carried out by the forensics department. Her body was finally buried on 21st September. Her father, Jazimin Abdul Jalil, had expressed his sorrow towards this tragedy, stating that whoever who caused her death was not a human being, but rather, an animal.
This was the result of an outrage of modesty (See Picture On The Right) caused by a man of age between 35 and 40, who was thought to be someone who enjoyed torturing people, particularly children. Along with him was a 23-year-old lady, who was apparently his partner in crime. The lady had been found and called for questioning by the Malaysian authorities, whereas the man has yet to be found. Hence, we are urging all of you here to play your part in finding this serial killer cum sexual offender and ensuring that justice is served to the deceased and her family.
If you know of the culprits’ whereabouts, keep us informed immediately, or directly inform her uncle, Jasni Abdul Jalil, via his blog, which he had specially created as a form of dedication to her.
Over the years, we have heard of children’s lives being taken away due to the evil doings of heartless adults. Nurin’s death was one of the most gruesome and tragic deaths that made many of us shocked, despaired and furious. Do you want more children to die in the hands of these sadistic people? Do you still wish to hear such saddening news of child abuse?Then let us do our part right away! Together we can make this world a better place for the little ones. Let us all join hand in hand and put a stop to such cruelty towards them once and for all! Fight against child abuse today.We have created a logo to show our support towards the fight against child abuse. If you would like to join in this movement, please copy and paste this article in your site and place the logo. After displaying this article, leave us a comment and we will add your link in our list of bloggers who have voluntarily helped us in this movement.
You can read the full article on the link below:
NAFASG©™: The Fight Against Child Abuse: A Tribute To The Late Nurin Jazlin (1999 to 2007): "The Fight Against Child Abuse: A Tribute To The Late Nurin Jazlin (1999 to 2007)"
In our times of darkness, children are the ones who will brighten us up. No matter what ordeals we have to endure in our daily lives, we know that we can overcome them the moment we set eyes on children. Their innocence and purity in them will always give us a sense of peacefulness and calm that is beyond words. And it goes without saying that life would be meaningless without seeing them smile, hearing them laugh and cry, and feeling their small and flawlessly gentle hands that want to reach out to us.
Yet, there are some who show no empathy and sensitivity towards these beautiful souls. Worse still, they would dunk themselves into physical violence and cruelty towards the children without even thinking twice. Such acts can deem someone to be worse than an animal, because even an animal has compassion and love for its young.
What is going on with this world? Why must such horrid acts be carried out? Why do these people ever exist in this world?
Please take this time to read this special message from us, and show your utmost support and sympathy towards the family of the late Nurin Jazlin, who passed away tragically and brutally at the age of only eight. Little Nurin Jazlin’s body was discovered in a gym bag on 17th September, one month after she was abducted. Upon the discovery, she was seen to be in the most horrifying state ever. Her hair was short and curled up, when it was originally straight and long. Her body was pale and badly bruised from head to toe, and there were traces of foreign objects like brinjal and cucumber found in the virginal area of her body.
Parents of the deceased took a long time to acknowledge her death, but eventually did after all the thorough DNA tests had been carried out by the forensics department. Her body was finally buried on 21st September. Her father, Jazimin Abdul Jalil, had expressed his sorrow towards this tragedy, stating that whoever who caused her death was not a human being, but rather, an animal.
This was the result of an outrage of modesty (See Picture On The Right) caused by a man of age between 35 and 40, who was thought to be someone who enjoyed torturing people, particularly children. Along with him was a 23-year-old lady, who was apparently his partner in crime. The lady had been found and called for questioning by the Malaysian authorities, whereas the man has yet to be found. Hence, we are urging all of you here to play your part in finding this serial killer cum sexual offender and ensuring that justice is served to the deceased and her family.
If you know of the culprits’ whereabouts, keep us informed immediately, or directly inform her uncle, Jasni Abdul Jalil, via his blog, which he had specially created as a form of dedication to her.
Over the years, we have heard of children’s lives being taken away due to the evil doings of heartless adults. Nurin’s death was one of the most gruesome and tragic deaths that made many of us shocked, despaired and furious. Do you want more children to die in the hands of these sadistic people? Do you still wish to hear such saddening news of child abuse?Then let us do our part right away! Together we can make this world a better place for the little ones. Let us all join hand in hand and put a stop to such cruelty towards them once and for all! Fight against child abuse today.We have created a logo to show our support towards the fight against child abuse. If you would like to join in this movement, please copy and paste this article in your site and place the logo. After displaying this article, leave us a comment and we will add your link in our list of bloggers who have voluntarily helped us in this movement.
You can read the full article on the link below:
NAFASG©™: The Fight Against Child Abuse: A Tribute To The Late Nurin Jazlin (1999 to 2007): "The Fight Against Child Abuse: A Tribute To The Late Nurin Jazlin (1999 to 2007)"
Sports for mental health;The DATRC experience
Last Wednesday at the Drug Addiction Treatment and Rehabilitation Centre(DATRC),a white woman who is one of group of folks visiting the Vom Christian Hospital on vacation from the UK came into the unit with some sport equipments. She came with the sole purpose of teaching the patients or clients some of these games as well as to donate these equipments to the centre so that the patients may be playing it in their recreation time.
That day we all went out, both the patients as well as the staff, to learn what she called Quick Cricket. I had always watched with amazement when Cricket is played on the TV and I used to wonder what it was all about.Well,that day, I leant about the wicket, the bowler and the baton. I learnt how the game is counted i.e. the run. It is rather very interesting I must say, and I am now looking forward to watching a game of cricket on the T.V.Incidentally,Nigeria is not a cricket playing nation. I must sat that before now I never saw a game of cricket played live before. The same cannot be said of other games like Volley ball, Basket ball,Handball,Hockey and a host of other games which though not as popular as Football in Nigeria, nevertheless we are not totally ignorant of.
In order to consolidate on what we have learnt,we also had another round of games two days ago. This time there were two groups, with each group playing cricket and volley ball respectedly.As you must have guessed, I opted for cricket and this time discovered that I was rather better at bowling. I thoroughly enjoyed myself. I am really thinking now of how I can be playing the game on a regular basis in order to keep in shape and lose weight. It is rather more interesting and motivating than just jogging.
Apart from the above sentiments, the import of what these white folks did those days should not be lost on us. These people had left the comfort of their home and country to try and touch the lives of people in other lands. They are Christians who know that there are a whole lot of ways by which one can spread the love of Jesus. They have chosen to spread this love simply by teaching these patients how to play games and donating sporting equipments to the centre to promote the regular playing of the game. This surely is a way to touch peoples’ lives and leave an indelible mark in the heart.
Monday, November 19, 2007
Good Samaritan Rehabilitation home;matters arising.
When I was going to the Drug Addiction Treatment and Rehabilitation Centre that day,I had it in mind to update the histories of some of the patients whose histories were not clear enough for me to really appreciate the extent of their problems.However,I was only able to take a full history of just one of the patients. The patient I interviewed was really lucid in his descriptions of the problems and gave graphic illustrations of the episodes which led to his admission.
Just as I finished taking my history in a rough form and set about organizing it and putting it on paper,one of the clinical psychologists came in and we set at talking about his psychological assessments of some of the patients with special emphasis on the patient that I just finished seeing.
From there, our discussions shifted to a number of other general issues as it relates to the poor state of mental health facilities in Nigeria especially the fact that there are just a few psychiatric hospitals and departments and very few rehabilitation centres as well. We drifted to a recent announcement made by the government of Plateau state closing down the Good Samaritan Rehabilitation home located at Sabo Gidan Kanan Road,Bukuru,Jos.The announcement said that the home was involved in unorthodox and dehumanizing practices in the management of the mentally ill in the center.
From what I gathered, the place is under the authority of the State Ministry of women affairs and social development but it seems to have lost the supervisory functions due to the neglect by successive governments. However the Jang administration seems to be looking into all the different sections of the society with a bid to improve the quality of life on the Plateau and as such this center came under searchlight.
According to unofficial reports, there are about 29 mentally ill people in the center being managed by someone who is neither a doctor, psychiatrist or Psychiatric nurse. One wonders how such came to be and what qualifications this fellow has to put him in this position. The caliber of people in that home are more or less vagrant psychotic people who may not have anywhere else to go. It is reported that many of them were taken off the street by this fellow at the report of the host community. The category of people in the home include chronic schizophrenics, drug addicts and other people who may not be able to even locate their homes if they are made to go home.
There was the idea that this fellow running the home, whoever he may be saw a need and set at providing such in the absence of government input. Given that he may not be the best qualified to be doing this, but in a situation where the relevant agencies that are responsible and elected leaders that have sworn to defend the constitution and provide for the overall welfare of her citizens fail in their duties, then anybody will do it.
The issue is not that action should not be taking to right the wrong going on in that place, but the question is ;what happens to the patients if that place is closed and alternate provision is not made for them. If some of them were picked from the street and they don’t know where to go, do we then send them back to the streets? Given that the facilities of JUTH is already overstretched in serving about 5-6 states, how then do we accommodate the patients from that home.
This may be an opportunity for the government to demonstrate her commitment to the overall health of the people, both physical and mental. It will really go a long way to help if the government retain the use of that place,re-staff it appropriately and maybe have an arrangement with the Psychiatry department of JUTH to send residents for at least a weekly evaluation of the patients pending a full employment of a psychiatrist if the need be. It must be noted that the Psychiatric hospital Uselu has a similar facility at Mile-18 of the Benin-Lagos express road and it is adequately covered from the main hospital.
Just as I finished taking my history in a rough form and set about organizing it and putting it on paper,one of the clinical psychologists came in and we set at talking about his psychological assessments of some of the patients with special emphasis on the patient that I just finished seeing.
From there, our discussions shifted to a number of other general issues as it relates to the poor state of mental health facilities in Nigeria especially the fact that there are just a few psychiatric hospitals and departments and very few rehabilitation centres as well. We drifted to a recent announcement made by the government of Plateau state closing down the Good Samaritan Rehabilitation home located at Sabo Gidan Kanan Road,Bukuru,Jos.The announcement said that the home was involved in unorthodox and dehumanizing practices in the management of the mentally ill in the center.
From what I gathered, the place is under the authority of the State Ministry of women affairs and social development but it seems to have lost the supervisory functions due to the neglect by successive governments. However the Jang administration seems to be looking into all the different sections of the society with a bid to improve the quality of life on the Plateau and as such this center came under searchlight.
According to unofficial reports, there are about 29 mentally ill people in the center being managed by someone who is neither a doctor, psychiatrist or Psychiatric nurse. One wonders how such came to be and what qualifications this fellow has to put him in this position. The caliber of people in that home are more or less vagrant psychotic people who may not have anywhere else to go. It is reported that many of them were taken off the street by this fellow at the report of the host community. The category of people in the home include chronic schizophrenics, drug addicts and other people who may not be able to even locate their homes if they are made to go home.
There was the idea that this fellow running the home, whoever he may be saw a need and set at providing such in the absence of government input. Given that he may not be the best qualified to be doing this, but in a situation where the relevant agencies that are responsible and elected leaders that have sworn to defend the constitution and provide for the overall welfare of her citizens fail in their duties, then anybody will do it.
The issue is not that action should not be taking to right the wrong going on in that place, but the question is ;what happens to the patients if that place is closed and alternate provision is not made for them. If some of them were picked from the street and they don’t know where to go, do we then send them back to the streets? Given that the facilities of JUTH is already overstretched in serving about 5-6 states, how then do we accommodate the patients from that home.
This may be an opportunity for the government to demonstrate her commitment to the overall health of the people, both physical and mental. It will really go a long way to help if the government retain the use of that place,re-staff it appropriately and maybe have an arrangement with the Psychiatry department of JUTH to send residents for at least a weekly evaluation of the patients pending a full employment of a psychiatrist if the need be. It must be noted that the Psychiatric hospital Uselu has a similar facility at Mile-18 of the Benin-Lagos express road and it is adequately covered from the main hospital.
Wednesday, November 14, 2007
DRUG ABUSE;A MALADAPTIVE COPING STRATEGY.
I was at the Drug Addiction Treatment and Rehabilitation center(DATRC) of the Vom Christian hospital today.It was really a time of revelations into some of the underlying problems of drug abuse and dependence.It had been said that drug abuse is only a symptom of a deeper problem in the life of a individual.
The Clinical Psychologist had earlier sometimes last week gave an assignment to everybody to write the benefit they derived from using whatever drug they were using.
For some reasons the patients just did not see any need in writing it but rather prefered to just talk about it.As a matter of fact,one of them said that he convinced the others against it because whatever they may have as benefit will surely be countered by the Psychologist.He really proved right the motive of the exercise as it was becoming as if the patients were just playing along with the Psychologists and whatever insight they think they have is just to play along and not coming from he inside.
Each individual introduced himself and the drugs they were abusing and what they believed they were benefiting from such.Among the answers giving include the following;
-A feeling of highness.
-To have courage and confidence to approach ladies.
-It gives inspiration
-To kill boredom in the face of unemployment.
-To lifts depression.
-To get strength.
-To be able to confront others.
-To improve appetite
-To get a calming effect.
-To manage anger.
-To be able to talk in public.
-To fill an emptiness within.
The striking point about all the above is that there is an underlying lack of self esteem and feeling of inadequacy,leading to a maladaptive coping strategy.The partinent thing therefore will be to address these inadequacies,change the thinking pattern of these individuals and give them an alternative and effective coping strategy that they can identify with.
It was an interesting session indeed and a couple of them seem to be well motivated already,being very outspoken that whatever benefit they think they derived from their drugs are not cogent reasons to continue because of the enormosity of what they have lost in terms of financial,social and physical well being.
The Clinical Psychologist had earlier sometimes last week gave an assignment to everybody to write the benefit they derived from using whatever drug they were using.
For some reasons the patients just did not see any need in writing it but rather prefered to just talk about it.As a matter of fact,one of them said that he convinced the others against it because whatever they may have as benefit will surely be countered by the Psychologist.He really proved right the motive of the exercise as it was becoming as if the patients were just playing along with the Psychologists and whatever insight they think they have is just to play along and not coming from he inside.
Each individual introduced himself and the drugs they were abusing and what they believed they were benefiting from such.Among the answers giving include the following;
-A feeling of highness.
-To have courage and confidence to approach ladies.
-It gives inspiration
-To kill boredom in the face of unemployment.
-To lifts depression.
-To get strength.
-To be able to confront others.
-To improve appetite
-To get a calming effect.
-To manage anger.
-To be able to talk in public.
-To fill an emptiness within.
The striking point about all the above is that there is an underlying lack of self esteem and feeling of inadequacy,leading to a maladaptive coping strategy.The partinent thing therefore will be to address these inadequacies,change the thinking pattern of these individuals and give them an alternative and effective coping strategy that they can identify with.
It was an interesting session indeed and a couple of them seem to be well motivated already,being very outspoken that whatever benefit they think they derived from their drugs are not cogent reasons to continue because of the enormosity of what they have lost in terms of financial,social and physical well being.
A COMMITMENT TO MENTAL HEALTH,SERVICE AND EXCELLENCE.
The department of Psychiatry,Jos University Teaching Hospital seems to be heading for a new lease of life.There had been calls in recent times to revamp the place in terms of the academic pursuits and structured programms that will make anybody that just strictly follow it come out with excellence.
Last week we held a meeting in which the head of department gave a lot of programms that are lined up for next year.Much of it boils down to the issue of advocacy and medical education for the community in which we are.If what we heard that day are coming to fruition,then we have a lot of activities on our hands next year.However we may start enjoying this from the latter part of this year as the H.O.D has extracted a promise from one of the past members of the department now practising abroad to come and give a guest lecture to the whole hospital community as well as to conduct some training sessions for the residents in the department.
The aim of all these is to make the quality of training in the department comparable to the best in any other center in the country.
Some of the programms that he highlighted that we might be having include;
-Workshop on substance abuse
-Workshop for teachers on mental health as well as substance use in school children.
-Workshop on incorporating mental health into primary health care.
-Quality of life in health and disease.
-Stress management in the work place
-A qurterly programm on T.V on mental health.
-Community mental health.
If all these are achieved, then the department is surely going to be a beehive of activities next year.And as might be expected,a lot is going to be expected of the residents in terms of coming up with quality work and materials to make a success out of all the above mentioned.
In another development,it was really a joyful thing that the candidate presented by the department at the part one examination of the National Postgraduate Medical college came out as the best candidate.This is really a thing of joy as departments of Surgery and Family Medicine produced the best candidates respectively at the same exam last year.It is high time Psychiatry also stood up and deliver.Sequel to this,our seminar presentations are proposed to be more vibrant in terms of content and delivery,there are going to be more clinical presentations as well as journal reviews.
With all the above in place we hope that very soon,we are going to be a reference for excellence in the country.Moreover our community and patients will be better for it.
Last week we held a meeting in which the head of department gave a lot of programms that are lined up for next year.Much of it boils down to the issue of advocacy and medical education for the community in which we are.If what we heard that day are coming to fruition,then we have a lot of activities on our hands next year.However we may start enjoying this from the latter part of this year as the H.O.D has extracted a promise from one of the past members of the department now practising abroad to come and give a guest lecture to the whole hospital community as well as to conduct some training sessions for the residents in the department.
The aim of all these is to make the quality of training in the department comparable to the best in any other center in the country.
Some of the programms that he highlighted that we might be having include;
-Workshop on substance abuse
-Workshop for teachers on mental health as well as substance use in school children.
-Workshop on incorporating mental health into primary health care.
-Quality of life in health and disease.
-Stress management in the work place
-A qurterly programm on T.V on mental health.
-Community mental health.
If all these are achieved, then the department is surely going to be a beehive of activities next year.And as might be expected,a lot is going to be expected of the residents in terms of coming up with quality work and materials to make a success out of all the above mentioned.
In another development,it was really a joyful thing that the candidate presented by the department at the part one examination of the National Postgraduate Medical college came out as the best candidate.This is really a thing of joy as departments of Surgery and Family Medicine produced the best candidates respectively at the same exam last year.It is high time Psychiatry also stood up and deliver.Sequel to this,our seminar presentations are proposed to be more vibrant in terms of content and delivery,there are going to be more clinical presentations as well as journal reviews.
With all the above in place we hope that very soon,we are going to be a reference for excellence in the country.Moreover our community and patients will be better for it.
Monday, November 12, 2007
OF CANNABIS USE AND MENTAL ILLNESS
A couple of posts ago a reader of mine actually asked to know about the link
between cannabis and mental illness.I promised to give him as candid an
opinion as possible.I had been distracted by a couple of incidences since
then.However, seeing the patients on rehabilitation at the Vom Christian
hospital brought back my consciousness to my responsibilty of educating
the young one out there,who get into the habit of using drugs either by
curiousity or peer pressure only to set themselves on the part of
self-destruct.
There are evidences to the fact that cannabis use has a strong link to mental illness.The mental effect of cannabis can be grouped into the following;
1.Psychological effect such as panics,anxiety,depression and Psychosis.These are also called 'toxic' effects because they result from exccessive consumption of the drug.
2.The effect of cannabis as a risk factor for mental illness and its effect on pre-existing mental illness.
3.Dependency or withdrawal effects
Of need for further consideration is the association of cannabis with psychosis.The partinent question is ;did cannabis merely precipitate an underlying psychosis or is there a cannabis psychosis?
Cannabis use may precipitate a psychosis in the following ways;
1.Acute use of large doses of the drug may induce a toxic or organic psychosis with symptoms of confusion and hallucination, which remit on abstinence.
2.Cannabis use may lead to an acute functional psychosis, similar to an acute schizophrenia-like state and lacking the organic features of a toxic psychosis.
3.Cannabis use may lead to a chronic psychosis, which persists after abstinence.
4.Long-term cannabis use may lead to an organic psychosis which only partially remits after abstinence, leaving a residual deficit state, sometimes called an amotivational syndrome, which is thought to be analogous to the chronic organic brain syndrome seen after prolonged misuse of alcohol.
5.Cannabis use may be a risk-factor for serious mental illness such as schizophrenia.
There are also acute toxic psychotic symptoms like disorientation,impaired memory, confusion, reduced attention span and disordered thinking with labile effect and hallucinations. These symptoms may resolve within a week.
Another condition worth nothing is the ' amotivational syndrome’ described as personality deterioration with loss of energy and drive to work.
There is also a lot of arguement on whether cannabis worsens the symptoms of schizoprenia or not,but a lot of studies have confirmed that cannabis worsens positive symtoms of schizophrenia.
There is also the issue of dependence with all the social,psychological and financial sequelae and consequenses.
However,not all people who smoke cannabis will come down with any of the above mentioned.Other factors that influence the vulnerability to develop a mental illness include :
1.Age of the patient with the possibility increasing with the younger the patient is.
2.Use of other psychoactive substances.
3The personality of the patient.
4.The genetic pre-disposition.
In conclusion,there are overwhelming evidences to show that cannabis has a lot of psychiatric complications resulting from its use.
between cannabis and mental illness.I promised to give him as candid an
opinion as possible.I had been distracted by a couple of incidences since
then.However, seeing the patients on rehabilitation at the Vom Christian
hospital brought back my consciousness to my responsibilty of educating
the young one out there,who get into the habit of using drugs either by
curiousity or peer pressure only to set themselves on the part of
self-destruct.
There are evidences to the fact that cannabis use has a strong link to mental illness.The mental effect of cannabis can be grouped into the following;
1.Psychological effect such as panics,anxiety,depression and Psychosis.These are also called 'toxic' effects because they result from exccessive consumption of the drug.
2.The effect of cannabis as a risk factor for mental illness and its effect on pre-existing mental illness.
3.Dependency or withdrawal effects
Of need for further consideration is the association of cannabis with psychosis.The partinent question is ;did cannabis merely precipitate an underlying psychosis or is there a cannabis psychosis?
Cannabis use may precipitate a psychosis in the following ways;
1.Acute use of large doses of the drug may induce a toxic or organic psychosis with symptoms of confusion and hallucination, which remit on abstinence.
2.Cannabis use may lead to an acute functional psychosis, similar to an acute schizophrenia-like state and lacking the organic features of a toxic psychosis.
3.Cannabis use may lead to a chronic psychosis, which persists after abstinence.
4.Long-term cannabis use may lead to an organic psychosis which only partially remits after abstinence, leaving a residual deficit state, sometimes called an amotivational syndrome, which is thought to be analogous to the chronic organic brain syndrome seen after prolonged misuse of alcohol.
5.Cannabis use may be a risk-factor for serious mental illness such as schizophrenia.
There are also acute toxic psychotic symptoms like disorientation,impaired memory, confusion, reduced attention span and disordered thinking with labile effect and hallucinations. These symptoms may resolve within a week.
Another condition worth nothing is the ' amotivational syndrome’ described as personality deterioration with loss of energy and drive to work.
There is also a lot of arguement on whether cannabis worsens the symptoms of schizoprenia or not,but a lot of studies have confirmed that cannabis worsens positive symtoms of schizophrenia.
There is also the issue of dependence with all the social,psychological and financial sequelae and consequenses.
However,not all people who smoke cannabis will come down with any of the above mentioned.Other factors that influence the vulnerability to develop a mental illness include :
1.Age of the patient with the possibility increasing with the younger the patient is.
2.Use of other psychoactive substances.
3The personality of the patient.
4.The genetic pre-disposition.
In conclusion,there are overwhelming evidences to show that cannabis has a lot of psychiatric complications resulting from its use.
Drug Addiction Treatment And Rehabilitation Centre of the Vom Christian Hospital;A ray of hope for the addicted.
I was at the Drug Addiction Treatment And Rehabilitation Centre of the Vom Christian hospital today.As I said yesterday,I will be having my posting there for the next 6-weeks.There were a total of 26 patients on admission,and because I and my colleague were seing them for the first time,we had to go into details in order to get to know them well.
There is a vaste variety of cases,but the most common were of people who were dependent on either alcohol,cannabis,nicotine or a combination of two or all of these.There was no one with dependence on things like cocaine or heroine because these are exotic and more expessive drugs.
There are some cases of frank psychotic disorders as well, including schizophrenia without any history of substance use,who got into the place one way or the other and there were also cases of schizophrenia with co-morbid substance use.But a good number of them have had their psychotic disorder cleared in JUTH before being refered there.Some also came directly there because it is not their first attempt at rehabilitation.
As must be expected from what I wrote in the last post,the majority of the patients were
dependent on alcohol.The extend to which alcohol is affecting people's lives can only be appreciated when one sees young people who otherwise would have been making academic,business and other forms of exploits wasting away.
Surely,the drug addiction treatment and rehabilitation centre is a very appropriate and welcomed development given the fact that the Psychiatric department of JUTH is pressed for space and is largely a short stay hospital
One only hopes that there will be adequate provisions for follow up of these patients in other to consolidate on the gains achieved during their rehabilitation.I mean there is a strong need to form support and self groups for long term support in the mode of the popular Alcohol Anonymous(A.A)
There is a vaste variety of cases,but the most common were of people who were dependent on either alcohol,cannabis,nicotine or a combination of two or all of these.There was no one with dependence on things like cocaine or heroine because these are exotic and more expessive drugs.
There are some cases of frank psychotic disorders as well, including schizophrenia without any history of substance use,who got into the place one way or the other and there were also cases of schizophrenia with co-morbid substance use.But a good number of them have had their psychotic disorder cleared in JUTH before being refered there.Some also came directly there because it is not their first attempt at rehabilitation.
As must be expected from what I wrote in the last post,the majority of the patients were
dependent on alcohol.The extend to which alcohol is affecting people's lives can only be appreciated when one sees young people who otherwise would have been making academic,business and other forms of exploits wasting away.
Surely,the drug addiction treatment and rehabilitation centre is a very appropriate and welcomed development given the fact that the Psychiatric department of JUTH is pressed for space and is largely a short stay hospital
One only hopes that there will be adequate provisions for follow up of these patients in other to consolidate on the gains achieved during their rehabilitation.I mean there is a strong need to form support and self groups for long term support in the mode of the popular Alcohol Anonymous(A.A)
Sunday, November 11, 2007
GOSKOLO;THE PHENOMENAL ALCOHOL CONSUMPTION ON THE PLATEAU.
Recently,the government of Governor Jonah Jang of Plateau state launched a campaign against the consumption of alcohol in Plateau state.The campaign includes a set of jingles on the electronic media in the state.The jingles highlighted some very amusing pattern of behaviour in the comsumption of alcohol.It is very surprising to note that a lot of civil servants are said to first consume a lot of alcohol even before going to the office.As a consequence of this,the productivity of the work force is nothing to write home about.The jingles also highlighted the fact that many organs in the body are damaged by the large consumption of alcohol.There are also other aspects of social life that were highlighted by the jingles.This include the fact that many a father are so engrossed in the act of hanging out late in the night in bars and drinking joints to the fact that their children do not even know them well as the children would have slept before the father comes home and the children will not be up before the father goes out the following morning!
One must really commend the effort of the government in bringing to fore this social ill.The government even went further to restrict the activities of bars and beer parlours,as they must close early these days.According to some social commentators,all these efforts of the government is yielding some good results as the civil service is more vibrant and some fathers are getting more responsible and visible at home.There is however no objective way of measuring this as at yet.
Another interesting thing is that the vaste majority of people who consume large amount of alcohol are not able to consistently afford the more expensive beers or wines and as such resort to taking the locally brewed 'BURUKUTU' or GOSKOLO'.Now,goskolo is otherwise called 'OGOGORO' in other parts of the country.It is largely cheaper and more dangerious than the other forms of alcohol because it not only contains ethanol(the normally consumed alcohol),but also methanol which is not a consumable form of alcohol.This is because the brewing process is not very refined.
There is a wide range of psychiatric conditions that are associated with alcohol intake.The ICD 10 has given the categories of the clinical conditions(as it also applies to other psychoactive substances)to be;
Acute intoxication,
Harmful use
Dependence syndrome
Withdrawal state
Withdrawal state with delirium
Psychotic disorders
Amnesic syndrome
Residual and late-onset psychotic disorder
Other mental and behavioural disorders
unspecified mental and behavioural disorder.
There was a time when I held the erronious believe that alcoholism was not a problem for africans.Well,I have come to discard such uninformed believes.As a matter of fact,I have seen quite a large number of peolple who are dependent on alcohol,or with one form or the other of alcohol induced psychotic disorder both in Uselu and now in Jos.This is almost on a daily basis.It is really amazing!
Tomorrow,I wll be dealing exclusively with people who are dependent on alcohol and other psychoactive substances as I will be having a 6-weeks posting at the Vom Christian hospital.This is the drug unit in affiliate with the Psychiatric Department of Jos University Teaching Hospital.The unit imbibes all the standard methods involved in detoxification and rehabilitation.Well, I hope to learn all to be learnt and I will keep you up to date with my experiences on this blog
One must really commend the effort of the government in bringing to fore this social ill.The government even went further to restrict the activities of bars and beer parlours,as they must close early these days.According to some social commentators,all these efforts of the government is yielding some good results as the civil service is more vibrant and some fathers are getting more responsible and visible at home.There is however no objective way of measuring this as at yet.
Another interesting thing is that the vaste majority of people who consume large amount of alcohol are not able to consistently afford the more expensive beers or wines and as such resort to taking the locally brewed 'BURUKUTU' or GOSKOLO'.Now,goskolo is otherwise called 'OGOGORO' in other parts of the country.It is largely cheaper and more dangerious than the other forms of alcohol because it not only contains ethanol(the normally consumed alcohol),but also methanol which is not a consumable form of alcohol.This is because the brewing process is not very refined.
There is a wide range of psychiatric conditions that are associated with alcohol intake.The ICD 10 has given the categories of the clinical conditions(as it also applies to other psychoactive substances)to be;
Acute intoxication,
Harmful use
Dependence syndrome
Withdrawal state
Withdrawal state with delirium
Psychotic disorders
Amnesic syndrome
Residual and late-onset psychotic disorder
Other mental and behavioural disorders
unspecified mental and behavioural disorder.
There was a time when I held the erronious believe that alcoholism was not a problem for africans.Well,I have come to discard such uninformed believes.As a matter of fact,I have seen quite a large number of peolple who are dependent on alcohol,or with one form or the other of alcohol induced psychotic disorder both in Uselu and now in Jos.This is almost on a daily basis.It is really amazing!
Tomorrow,I wll be dealing exclusively with people who are dependent on alcohol and other psychoactive substances as I will be having a 6-weeks posting at the Vom Christian hospital.This is the drug unit in affiliate with the Psychiatric Department of Jos University Teaching Hospital.The unit imbibes all the standard methods involved in detoxification and rehabilitation.Well, I hope to learn all to be learnt and I will keep you up to date with my experiences on this blog
Tuesday, November 6, 2007
PHIL WILSON,A MODEL IN ADVOCACY.
The hall of the conference hall of Jos University Teaching Hospital was already full when I got in.I was almost not going to get a seat,but I was given a seat by the catering girls.Surely it is going to be a remarkable day with the turn out of people.The president of the Association of Resident Doctors JUTH chapter introduced the different guests.It was really an array of policy makers and NGOs linked with HIV/AIDS in Plateau State.Such a list wet my appetite in readiness for what was to come.When the guest speaker took the floor,he spoke with the convinction of someone who has seen it all.He spoke from the heart rather than from the head.No doubt his training in the theater arts helps in his delivery and oratory prowess,but he could not have given such an eloquent delivery if his heart was not in it.
His name is Phil Wilson,the president and founder of Black AIDS Institute in the U.S.According to him,he has been living with HIV for the past 26years.He started his speech with the joke of a man of faith who was stranded in the middle of the sea and prayed to God to help him survive.Despite the fact that God sent him three different boats,he refused all with the insistent that he was waiting for God to save him.Well he died and God blame him in heaven for his foolishness.Phil Wilson was able to draw an analogy with the issue of antiretroviral drugs use,safe practices both sexually and otherwise and voluntary testing to know ones HIV status.
Acording to him,HIV/AIDS has now become a black disease in all its ramification and we should not blame our denial on faith!He solicited for a global coordinated black mass movement in the fight against HIV/AIDS.He further emphasised that government cannot write our community plan for us,we must all take the responsibility to save our race.He further postulated that 'none of us is safe,until all of us are safe'.He ended his speech with a beautifully composed poem,but that is very touching indeed.
At the end of the speech a lot of questions were asked that bordered on the issue of stigmatization,his challenges over the years with the use of anti-retroviral drugs and how he has been able to cope over the years.He was able to conclude that he has been helped by the love of his family and friends.He concluded that all of us may not be infected,but all of us are affected because we have at least an acquitance who is infected!
Surely,mental health advocacy can draw an inspiration from Phil Wilson.It is high time people with mental illnesses who are now very insightful into their illness and are stable came out openly to educate others about mental illness.This is going to seriously reduce stigma about mental illnesses.Though mental illnesses do not have the capacity of wiping off a generation like AIDS,it however has the capacity of shattering dreams,and rendering unproductive the young and promising if not properly managed.Their are a lot of people in high places who have a form or the other of mental illness who are silent about it and secretly seek medical help.If such people come out openly to talk about their experience and that they have been able to function well with proper medication and follow up,a lot of the misconceptions about mental illnesses will be dispelled.
You can find out more about the activities of BlacK AIDS Institute in their website as follows; http://blackaids.org/.
Please copy and paste in your browser if you are having problem with the link.
His name is Phil Wilson,the president and founder of Black AIDS Institute in the U.S.According to him,he has been living with HIV for the past 26years.He started his speech with the joke of a man of faith who was stranded in the middle of the sea and prayed to God to help him survive.Despite the fact that God sent him three different boats,he refused all with the insistent that he was waiting for God to save him.Well he died and God blame him in heaven for his foolishness.Phil Wilson was able to draw an analogy with the issue of antiretroviral drugs use,safe practices both sexually and otherwise and voluntary testing to know ones HIV status.
Acording to him,HIV/AIDS has now become a black disease in all its ramification and we should not blame our denial on faith!He solicited for a global coordinated black mass movement in the fight against HIV/AIDS.He further emphasised that government cannot write our community plan for us,we must all take the responsibility to save our race.He further postulated that 'none of us is safe,until all of us are safe'.He ended his speech with a beautifully composed poem,but that is very touching indeed.
At the end of the speech a lot of questions were asked that bordered on the issue of stigmatization,his challenges over the years with the use of anti-retroviral drugs and how he has been able to cope over the years.He was able to conclude that he has been helped by the love of his family and friends.He concluded that all of us may not be infected,but all of us are affected because we have at least an acquitance who is infected!
Surely,mental health advocacy can draw an inspiration from Phil Wilson.It is high time people with mental illnesses who are now very insightful into their illness and are stable came out openly to educate others about mental illness.This is going to seriously reduce stigma about mental illnesses.Though mental illnesses do not have the capacity of wiping off a generation like AIDS,it however has the capacity of shattering dreams,and rendering unproductive the young and promising if not properly managed.Their are a lot of people in high places who have a form or the other of mental illness who are silent about it and secretly seek medical help.If such people come out openly to talk about their experience and that they have been able to function well with proper medication and follow up,a lot of the misconceptions about mental illnesses will be dispelled.
You can find out more about the activities of BlacK AIDS Institute in their website as follows; http://blackaids.org/.
Please copy and paste in your browser if you are having problem with the link.
Saturday, November 3, 2007
APIN,SURELY PSYCHIATRY DESERVES BETTER THAN THIS!
A couple of days ago I made a post telling how I found a significant difference in psychiatry in a teaching hospital like I am presently as against a Psychiatric hospital like where I was before.Well, over the weeks I have found some other very important differences.Such include the rate at which we practise laison psychiatry.We are called upon so regularly to review patients in the medical,obstetric and surgical departments.One common consult we usually have is that to see HIV positive patients who are having psychiatric manifestations.
It is now a well known fact that there are a number of psychiatric conditions that can be found in HIV/AIDS patients.These include things like suicidal ideation and attempts,substance abuse,anxiety,aparty,depression and dementia(including the AIDS Dementia complex).Others include mania and some other psychotic manifestations as well as some psychomotor symptoms.
It is therefore very surprising when I heard recently that APIN(AIDS PREVENTION INITIATION IN NIGERIA)located in JUTH is planning to hold a training on counselling HIV positive patients and that they are sending invitation to different departments to send people to attend the programme.As a matter of fact, I gathered that they asked for up to 20 participants from a department like Haematology who did not reply as promptly to their request and not a single invitation to a department like Psychiatry!This is simply unacceptable.It is high time Psychiatry is fully integrated into the scheme of things concerning the prevention and management of HIV/AIDS.
As a matter of fact, I gathered that there was a researcher who came from abroad and collected data on psychiatric conditions among patients being managed at APIN.However,while a foreigner has recognised this and even did a good work on it,our own people could not recognise the importance of Psychiatry in the management of HIV positive patients and thereby extend invitation to Psychiatry to participate in the up coming programme!This is another classical example of how other doctors and nurses from other departments and the general public undermine the importance and relevance of Psychiatry.However,the relevance of Psychiatry is increasing daily and cannot further be ignored!
The American Psychiatric Association have a good manual called PRACTICE GUIDELINE in the treatment of patients with hiv-aids and it can be assessed on the following link;
http://www.psych.org/psych_pract/treatg/pg/HIV_AIDS_05-15-06.pdf
It is now a well known fact that there are a number of psychiatric conditions that can be found in HIV/AIDS patients.These include things like suicidal ideation and attempts,substance abuse,anxiety,aparty,depression and dementia(including the AIDS Dementia complex).Others include mania and some other psychotic manifestations as well as some psychomotor symptoms.
It is therefore very surprising when I heard recently that APIN(AIDS PREVENTION INITIATION IN NIGERIA)located in JUTH is planning to hold a training on counselling HIV positive patients and that they are sending invitation to different departments to send people to attend the programme.As a matter of fact, I gathered that they asked for up to 20 participants from a department like Haematology who did not reply as promptly to their request and not a single invitation to a department like Psychiatry!This is simply unacceptable.It is high time Psychiatry is fully integrated into the scheme of things concerning the prevention and management of HIV/AIDS.
As a matter of fact, I gathered that there was a researcher who came from abroad and collected data on psychiatric conditions among patients being managed at APIN.However,while a foreigner has recognised this and even did a good work on it,our own people could not recognise the importance of Psychiatry in the management of HIV positive patients and thereby extend invitation to Psychiatry to participate in the up coming programme!This is another classical example of how other doctors and nurses from other departments and the general public undermine the importance and relevance of Psychiatry.However,the relevance of Psychiatry is increasing daily and cannot further be ignored!
The American Psychiatric Association have a good manual called PRACTICE GUIDELINE in the treatment of patients with hiv-aids and it can be assessed on the following link;
http://www.psych.org/psych_pract/treatg/pg/HIV_AIDS_05-15-06.pdf
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