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Biomedical subjects

D M Ndetei

Publications and source records attributed to D M Ndetei.

At least 19 recordsLinked to original sources
PubMed2006

Psychometric properties of an African symptoms check list scale: the Ndetei-Othieno-Kathuku scale.

OBJECTIVES: To profile and quantify the psychometric properties of the NOK (Ndetei-Othieno-Kathuku) scale against internationally used Gold-standards and benchmarks for mild psychiatric disorders and post-traumatic stress disorders and to provide a potential easy to administer culture sensitive instrument for screening and assessing those with possible psychiatric disorders for the Kenyan and similar social-cultural situations. DESIGN: Cross-Sectional quantitative study. SETTING: A psychiatric clinical consultation setting and Kyanguli Secondary School psychotrauma counselling clinical set-up. SUBJECTS: Survivors of the Nairobi USA Embassy bombing who were referred for psychiatric treatment and survivors of a fire disaster from a rural Kenyan school (Kyanguli School fire disaster) including students, parents of the diseased children and staff members. RESULTS: Positive correlation was found between the NOK and all the instruments. The highest correlations were between the NOK and the BDI and SCL-90 (r = 0.557 to 0.786). The differences between the NOK scores among the different groups were statistically significant (F ratio = 13.54 to 160.34, p < 0.01). The reliability coefficient (internal consistency) of the scale, alpha = 0.9733. Other item statistics and correlations of the scale are discussed. CONCLUSION: It is concluded that the NOK has high concurrent and discriminant validity as well as a high internal consistency and that it can be used for the rapid assessment of psychotrauma victims of all age groups; and stress in general in similar age groups in the local setting. It is culture appropriate and sensitive.

Adolescent↗
PubMed2006

Post traumatic stress disorder among Mau Mau concentration camp survivors in Kenya.

BACKGROUND: A decade before Kenya's independence in 1963 thousands of 'Mau Mau' fighters were arrested and incarcerated in concentration camps where many underwent torture and inhuman treatment. No studies have been done to establish the presence of post traumatic stress disorder (PTSD) and other psychiatric morbidity among the survivors of those concentration camps. OBJECTIVES: To establish the prevalence of PTSD and other psychiatric morbidity and associated factors among the Mau Mau Concentration Camp survivors. DESIGN: A cross-sectional, descriptive study of all consecutive concentration camp survivors included in the study. SETTING: Mau Mau War Veterans' Association (MMWVA) headquarters at Mwea House, Nairobi, Kenya Human Rights Commission headquarters in Nairobi, Tumaini House (Venue of MMWVA elections, 2005) and the MMWVA branch office in Kajiado District, Rift Valley Province, Kenya. SUBJECTS: One hundred and eighty one Mau Mau Concentration Camp Survivors who gave consent to participate in the study. MAIN OUTCOME MEASURES: Lifetime and Current PTSD, IES-R score and other Psychiatric Morbidity as measured using the SCID and the IES-R. RESULTS: A DSM-IV-TR diagnosis of current PTSD was made in 65.7% of the survivors. Current PTSD was associated with higher IES-R scores and older age, lower income, non-Catholic religion, larger household size, older age at incarceration, greater length of incarceration, incarceration in two or more camps, experiencing other traumatic events, family history of mental illness and having other psychiatric illness. CONCLUSIONS: Similar to other former Prisoners of War (POWs) elsewhere, these survivors suffer high PTSD prevalence rates and a special veterans' service is recommended to address this problem and its associated factors among these and other veterans in Kenya.

Aged↗
PubMed2004

Post traumatic stress disorder among motor vehicle accident survivors attending the orthopaedic and trauma clinic at Kenyatta National Hospital, Nairobi.

OBJECTIVES: To determine the prevalence rate of post traumatic stress disorder (PTSD) and associated risk factors among motor vehicle accident (MVA) survivors attending the orthopaedic and trauma clinic at Kenyatta National Hospital, Nairobi. DESIGN: A cross-sectional study. SETTING: Kenyatta National Hospital, Nairobi. SUBJECTS: One hundred and ninety seven adult males and sixty seven female patients. METHOD: The 264 patients were interviewed using a questionnaire to collect the socio-demographic data, the Self Rating Questionnaire (SRQ) and the Impact of Event Scale-Revised (IES-R). Diagnosis was made using the Diagnostic and Statistical Manual (DSM-IV). RESULTS: The mean age was 34.63+/-12.71 years (range 18-65). Overall, the prevalence rate of PTSD was 13.3%. None of the cases had been previously diagnosed as having PTSD. Females had a higher rate of 17.9% (n = 67), compared to the males 11.7% (n=197). The majority of those with PTSD (42.9%) were young, 20 - 29 years. Other risk factors were having post-primary education (62.9%), experiencing the first motor vehicle accident (14.1%), previous psychiatric illness, and other medical illnesses. The type of accident, role/status and immediate reactions to the accident were not significant. CONCLUSIONS: PTSD following motor vehicle accidents is common. Although the MVA survivors do develop significant rates of PTSD, it is not easy to identify those at risk but some of the parameters documented in this study may help. A multi disciplinary approach is therefore essential in the management of the RTA survivors at the orthopaedic and trauma clinics if their physical and psychological needs are to be adequately addressed

Accidents, Traffic↗
PubMed2003

Psychiatric morbidity among children and young persons appearing in the Nairobi Juvenile Court, Kenya.

OBJECTIVES: To estimate the prevalence and pattern of psychiatric disorders among children and young persons appearing in the Nairobi juvenile court, Kenya. DESIGN: A point prevalence survey. SETTING: The Nairobi Juvenile Court, Kenya. SUBJECTS: Ninety (sixty-four males and twenty-six females) children and young persons aged 8 to 18 years classified as criminal offenders, group I (60), and those for protection and discipline, group II (30), were selected. METHOD: A socio-demographic questionnaire, reporting questionnaire for children (RQC), follow-up interview for children (FIC), present state examination (PSE) and clinical interview were administered to the subjects. International Classification of Diseases, 10th Edition (ICD-10) diagnostic criteria were used. RESULTS: The crude psychiatric morbidity (CPM) rate was 44.4%. ICD-10 documented psychiatric disorders detected in those with CPM were conduct disorders 45%, mixed disorders of conduct and emotion 20%, emotional disorders with onset specific to childhood 20%, mood disorders 12.5% and hyperkinetic disorders 2.5%. CONCLUSION: This study has shown a high presence of psychiatric morbidity in children and young persons appearing in the Nairobi Juvenile Court. These juveniles need and would benefit from mental treatment as recommended in section 18 of Cap 141 of the laws of Kenya; The Children's and Young Persons Act.

Adolescent↗
PubMed2003

Substance use among children and young persons appearing in the Nairobi Juvenile Court, Kenya.

OBJECTIVE: To estimate the prevalence and pattern of substance use among children and young persons appearing in the Nairobi Juvenile Court, Kenya. DESIGN: A point prevalence survey. SETTING: The Nairobi Juvenile Court, Kenya. SUBJECTS: Ninety (sixty four males and twenty six females) children and young persons aged 8 to 18 years classified as criminal offenders, group I (60) and those for protection and discipline, group II (30), were selected. METHOD: Socio-demographic and substance use questionnaires were administered to the subject. International classification of diseases, 10th Edition (ICD-10) diagnostic criteria were used. RESULTS: Crude rate for substance use in this study was found to be 39 out of the total sample of 90(43.3%), children and young persons. Of these thirty nine, 33 (85.8%) were males and six(14.2%) were females. Twenty nine (32.2%) used nicotine, 19(21.1%) used volatile hydrocarbons, 8(8.9%) used cannabis six (6.7%) used alcohol, five (5.6%) used khat and three (3.3%) used sedatives. Multiple substance use was also evident. CONCLUSION: This study has shown a high presence of substance use in children and young persons appearing in the Nairobi Juvenile Court.

Adolescent↗
PubMed2000

Substance abuse in outpatients attending rural and urban health centres in Kenya.

OBJECTIVES: To estimate the prevalence and pattern of substance use among patients attending primary health centres in urban and rural areas of Kenya. DESIGN: A descriptive cross-sectional prevalence survey. SETTING: Urban health centres of Jericho and Kenyatta University (KU) and rural health centres in Muranga district. SUBJECTS: One hundred and fifty adult patients (seventy eight males and seventy two females) were included in the study. INTERVENTION: Semi-structured questionnaires and the DSM IV diagnostic criteria were used to record the socio-demographic data and to determine substance dependence or abuse. RESULTS: The substances commonly used in descending order of frequency were alcohol, tobacco, khat and cannabis. Only alcohol and tobacco were extensively used. Lifetime prevalence rates of alcohol use for the two urban health centres were 54% and 62% compared to 54% for the rural health centres. For tobacco the lifetime prevalence rates were 30% for Jericho, 28% for KU and 38% for Muranga. The differences between the rural and urban samples were not statistically significant. More males than females had used alcohol (average lifetime use 80.8% for males compared to 30.6% for females: p<0.05) and tobacco (average lifetime use 56.4% for males compared to 5.6% for females p<0.05). CONCLUSION: The rates of substance abuse were generally low with the exception of alcohol and tobacco. Socio-cultural factors might be responsible for the differences noted. It is suggested that preventive measures and education should be emphasised at the primary care level.

Adult↗
PubMed1998

Study of psychiatric consequences of closed head injury at the Kenyatta National Hospital.

This was a study to compare the psychiatric consequences of closed head injury (CHI) in 37 patients with 39 demographically similar patients with fractured lower limb injury (FLLI), aged 16-55 years. The outcome measures were the Clinical Interview Schedule-Revised, the Bender Gestalt Test and the WHO AUDIT Core for alcohol abuse. The final diagnoses were made according to DSM-III-R diagnostic criteria. The findings indicated that CHI patients suffered more psychiatric consequences than FLLI controls (OR = 4.07; 95% CI = 1.30:13.14; p = 0.013). Depression and anxiety disorders were the most common problems encountered in these subjects.

Adolescent↗
PubMed1988

Psychiatric phenomenology across countries: constitutional, cultural, or environmental?

Some literature on the significance of culture on psychiatric phenomenology and also literature on psychiatric phenomenology in immigrants, particularly in Great Britain, are reviewed. It is pointed out that paranoid and religious phenomenology is particularly common in some immigrant groups and that this can be understood to some extent as a reflection of cultural factors. In order to elucidate more the role of culture in psychiatric phenomenology in immigrants to Great Britain the socio-cultural backgrounds of the immigrants and in particular the Africans, the West Indians and the Asians are discussed in some details. The phenomenology of psychiatric illness as recorded in a hospital based population of diverse cultural backgrounds in a London hospital was studied to see if any variations across the various cultural groups could be understood in terms of cultural factors. It was found that paranoid and religious phenomenology was more associated with African and West Indian groups for cultural reasons rather than their socio-environmental and racial status in Britain. Paranoia was directed to fellow immigrants rather than to the host population. It is concluded that paranoia and religious phenomenology do not necessarily have the same clinical significance in various cultural groups. It is also pointed out that hallucinations, and in particular auditory hallucinations and First Rank Symptoms of schizophrenia, which have assumed diagnostic significance in some cultures, may not necessarily have the same significance in other cultures.

Cross-Cultural Comparison↗
PubMed1986

Paranoid disorder--environmental, cultural or constitutional phenomenon?

At a London hospital the prevalence and types of recorded paranoid disorders, and their characteristics were extracted from the files of in-patients of various cultural groups. It was found that West Indians and Africans had more paranoid colouring in their psychiatric illness than any other group. Other immigrant groups had less paranoid features than the English group. The self or a family member was the commonest focus of intended harm in all the cultural groups. Supernatural modes of injury were common in the West Indians and Africans. It is argued that in immigrants paranoid disorder is not merely due to discrimination consequent on their migrant status, but that cultural factors inherent in the immigrants are also of etiological importance.

Body Constitution↗
PubMed1986

Experiences from a marital-sex therapy clinic in Nairobi.

Out of 100 first referrals to a newly started family/marital - sex therapy clinic in Nairobi, 52 cases were studied for sociodemographic characteristics, help-seeking pattern for their sexual problems, presentation of the sexual problems, factors that might sustain the sexual problems, types of sexual problems and the treatment approaches. There was a male preponderance. Both married and non-married patients were seen. The problems tended to occur in relatively young people, and for those who were married in relatively early years of their marriage. The patients attributed the causes of the sexual problems to physical rather than psychological factors, although objective assessment found relatively very few possible physical causes. Elementary rather than subtle psychological causes were frequent. These formed fertile grounds for intervention. The findings are discussed in the light of the social-cultural context in which they were obtained.

Adult↗
PubMed1985

Content of grandiose phenomenology across cultures.

The content of grandiose ideas and delusions in patients of various cultural groups admitted to a London psychiatric hospital were compared. There were no overall differences but certain trends were apparent. It was found that religion was the commonest content of grandiose symptoms in all the groups. Its frequency was higher in the African and Jamaican groups, an observation that can be understood from the cultural background of these groups. The other types of content, namely royals, identity and ability were less frequent in all groups.

Africa↗
PubMed1985

Cross-cultural study of religious phenomenology in psychiatric in-patients.

Case notes of patients from nine different cultural groups admitted to a London hospital were scrutinized for religious background and religious phenomenology. With the exception of preaching behaviour there were no statistically significant cultural differences, but certain trends were apparent. The pattern of religion in each cultural group could be understood in terms of the historical and geographical origins of these groups. Religious phenomenology was better explained in terms of deep-seated cultural factors rather than current religion.

Africa↗
PubMed1984

A cross-cultural comparative study of patterns of depression in a hospital-based population.

In a study of Catego depressive syndromes, using the Syndrome Check List and the Catego programme, no significant differences in depression symptomatology frequencies were found in nine different cultural groups of patients admitted to a London hospital. There were some differences in the frequencies of the hospital diagnoses of depression, whereas the Catego diagnoses showed greater similarity. It is argued that symptoms characteristic of depression in the West are common to all cultures and will become apparent on enquiry in conjunction with other culturally determined symptoms.

Cross-Cultural Comparison↗
PubMed1984

Pattern of anxiety in a cross-cultural hospital population.

In a study of the frequencies of hospital diagnoses of anxiety or related conditions and the Catego syndromes and diagnoses of anxiety and related conditions it was found that with the exception of the syndrome of tension, there were no overall cultural differences in the distribution of these syndromes across the nine cultural groups studied. However, the occurrence of these syndromes was barely reflected in the hospital diagnoses of anxiety and related conditions, even less so in the Catego diagnoses where one case of hysteria was found in the African group. All the symptoms of anxiety and related conditions are found in all the cultural groups notwithstanding other symptoms which may be culturally determined. It is argued that, at least in this hospital-based study, most or all of these symptoms were subordinate to other more predominant clinical or Catego diagnoses.

Anxiety Disorders↗
PubMed1984

Frequency and clinical significance of delusions across cultures.

The pattern of delusions in a cross-cultural hospital population was studied. It was found that there were cultural differences in persecutory, grandiose and religious, and sexual and fantastic delusions, accounted for mainly by the relatively higher frequencies in the African and West Indian cultural groups. These phenomena can be understood in terms of the cultural backgrounds of these groups. It is further argued that similarly defined persecutory delusions have a wide clinical significance that goes beyond schizophrenia in some cultural groups.

Africa↗