In Africa and Nigeria as a whole, awareness and knowledge of
Mental Disorder is extremely low making it difficult for such patients to
access adequate and prompt medical attention. Furthermore, factors like lack of
health facilities, inadequate skilled mental health practitioners, low
socioeconomic status and poor health seeking behavior further reduces the
number of patients getting proper mental health care.
Mental health as defined by WHO is “a state of well-being in
which every individual realizes his or her own potential, can cope with the
normal stresses of life, can work productively and fruitfully and is able to
make a contribution to her or his community”. It includes how we feel about
ourselves, how we feel about others and how we can meet the demands of life.
Mental Disorder on the other hand according to WHO is “the collectively all
diagnosable mental disorders or health conditions that are characterized by
alterations in thinking, mood or behavior associated with distress and/or
impaired functioning”. In this article, we will look at the 8 common mental
disorders affecting Nigerians.
1. Schizophrenia
It is the most severe form of functional mental illness
affecting most Nigerians and it is also found to be the most common mental
disorder worldwide. It is commonly described as a severe, chronic and disabling
mental disorder characterized by psychotic episodes with recurring functional
periods of disordered thought process. It mainly affects perception and
thinking hence giving rise to a spectrum of clinical scenarios. Common symptoms
of schizophrenia include; delusions, hallucinations, disturbance of thought,
disorganized speech, difficulty in concentration and poor memory.
2. Anxiety Disorders
This is a heterogeneous group of disorders with abnormal
fear and stress as the main underlying disorder. Anxiety is said to be
abnormal/a mental disorder when symptoms interfere with the individual’s normal
productive activities and its harmful effects outweigh its benefits because
fear and stress is necessary for human survival. An anxiety disorder involves
an excessive or inappropriate state of arousal characterized by feelings of
apprehension, uncertainty or fear. This disorders can be differentiated into
Generalized Anxiety Disorders (GAD), Panic Disorder (PD), Obsessive Compulsive
Disorder (OCD), Phobic Disorders (including social anxiety disorder),
Post-traumatic stress disorder (PTSD), Acute stress disorder, with each of them
having distinct clinical symptoms.
3. Personality Disorders
Personality disorders are defined by the American
Psychiatric Association (APA) as "an enduring pattern of inner experience
and behavior that deviates markedly from the expectations of the culture of the
individual who exhibits it." The beginning of these patterns of behavior
can typically be traced back to late adolescence and the beginning of
adulthood, and, in rare instances, childhood. This deviation from personality
is severe enough to affect the interaction of the patient with his/herself and
with the community.
Examples of personality disorder are Paranoid personality
disorder (excessive pervasive distrust and suspiciousness of others), Schizoid
personality disorder (detachment from social relationships and a restricted
range of expression of emotions), Schizotypal personality disorders (acute
discomfort with reduced capacity for close relationships). Others are
Obsessive-compulsive personality disorder, Antisocial, Histrionic (excessive
emotionality and attention seeking), Narcissistic personality disorder
(grandiosity in fantasy or behavior with need for admiration, and lack of
empathy), Avoidant and Dependent personality disorders.
4. Premenstrual Tension
This is a collection of physical, psychological and
emotional symptoms related to a woman’s menstrual cycle and should be severe
enough to interfere with some aspects of life. 80% of women have some of these
symptoms at one time or another during their menstrual cycle, but only 2-5%
meets the criteria for premenstrual tension. These symptoms are different from
the discomfort associated with menstruation. It is due to the changing level of
sex steroids accompanying ovulation during the menstrual cycle. Common symptoms
are irritability, emotional liability, headaches, anxiety, depression, weight
gain, breast pain, syncope. and paresthesias.
5. Postpartum Blues
It is a very common mental disorder as it occurs in about
50- 85% of women. Symptoms typically peak at about the 4 - 5 days
post-delivery. It may last for a few hours to a few days, resolving
spontaneously by 2 weeks after child birth. Symptoms include; mood lability,
tearfulness, anxiety, and irritability. Symptoms do not interfere with the
woman's ability to function.
6. Postpartum Depression
Usually occurs within the 1st 2 - 3 weeks post-delivery, but
may occur at any point after delivery. Milder depressive symptoms may have
occurred during the pregnancy and are usually not observed by the patient,
spouse or caregivers. Symptoms are similar to those of depression occurring at
other times in a woman's life. It affects 5 -25% of Nigerian women. Common
symptoms include; depressed mood, tearfulness, feelings of guilt, feelings of
worthlessness or incompetence, fatigue, sleep disturbance, change in appetite,
poor concentration. and suicidal thoughts.
7. Postpartum Psychosis
This is the most severe form of postpartum psychiatric
illness affecting Nigerian women after childbirth. It is a Psychiatric
emergency that needs urgent treatment by a psychiatrist. It occurs in 1-2% per
1000 Nigerian women after child birth. Its onset is usually with 48-72 hours
after delivery. Majority develop symptoms within the 1st 2/52 post-delivery.
Onset is usually sudden and it is characterized by severe aggressiveness, loud
cry/shouts, suicidal attempts to self and the baby.
8. Sleep Disorders
This is a spectrum of disorders affecting an individual’s
sleep. It can affect the quality, depth, pattern and rhythm of sleep. A bad
night’s sleep could produce: irritability, low efficiency, and productivity at
work, difficulty in school work, health and relationships also suffer.
Typically, there is difficulty initiating or maintaining sleep, Narcolepsy
which is the irresistible attacks of refreshing sleep occurring daily,
accompanied by episodes of brief loss of muscle tone (cataplexy), Sleep-wake
schedule disorder and other abnormalities that can occur during sleep.
Compiled by Chinedu Kanayochukuwu
Source:nigerian bulletin
