Original Research

Positive and negative symptoms of schizophrenia as correlates of help-seeking behaviour and the duration of untreated psychosis in south-east Nigeria

Paul Chigozie Odinka, A C Ndukuba, R C Muomah, M Oche, M U Osika, M O Bakare, A O Agomoh, R Uwakwe
South African Journal of Psychiatry | Vol 20, No 4 | a536 | DOI: https://doi.org/10.4102/sajpsychiatry.v20i4.536 | © 2014 Paul Chigozie Odinka, A C Ndukuba, R C Muomah, M Oche, M U Osika, M O Bakare, A O Agomoh, R Uwakwe | This work is licensed under CC Attribution 4.0
Submitted: 26 November 2013 | Published: 30 November 2014

About the author(s)

Paul Chigozie Odinka, Department of Psychological Medicine, College of Medicine, University of Nigeria Nsukka, Enugu State, Nigeria, Nigeria
A C Ndukuba, Department of Psychological Medicine, College of Medicine, University of Nigeria Nsukka, Enugu State, Nigeria, Nigeria
R C Muomah, Department of Psychological Medicine, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria, Nigeria
M Oche, Department of Psychological Medicine, Federal Medical Centre Makurdi, Benue State, Nigeria, Nigeria
M U Osika, Psychiatric Hospital, Rumuigbo Port Harcourt, Rivers State, Nigeria, Nigeria
M O Bakare, Federal Neuro-Psychiatric Hospital, New Haven, Enugu, Enugu State, Nigeria, Nigeria
A O Agomoh, Federal Neuro-Psychiatric Hospital, New Haven, Enugu, Enugu State, Nigeria, Nigeria
R Uwakwe, Department of Mental Health, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria, Nigeria

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Abstract

Background. Duration of untreated psychosis (DUP) has been widely recognised in recent years as a potentially important predictor of illness outcome, and the manifestations of schizophrenia have been known to influence its early recognition as a mental illness. 

Objective. To assess the association between the positive and negative symptoms of schizophrenia, help-seeking and DUP. 

Methods. We performed a cross-sectional study of 360 patients with schizophrenia, who had had no previous contact with Western mental health services. The Sociodemographic Questionnaire, World Health Organization Pathway Encounter Form and a questionnaire to establish DUP were used. The positive and negative syndrome scale and Composite International Diagnostic Interview were used for the assessment of mental disorders and to diagnose.

Results. Respondents who had predominant positive symptoms and who had a median DUP of 8 weeks or 24 weeks, tended to use psychiatric hospitals and other Western medical facilities, respectively, as their first treatment options. However, those who had predominant negative symptoms and who had a median DUP of 144 weeks or 310 weeks, tended to use faith healers and traditional healers, respectively, as first treatment options.

Conclusion. The predominance of negative symptoms could militate against early presentation among people with schizophrenia, probably because negative symptoms are poorly recognised as indicating mental illness in Nigeria, as they could be interpreted as deviant behaviour or spiritual problems that would require spiritual solutions.


Keywords

Symptoms; Perceptions; Schizophrenia; Help-seeking; Duration of Untreated Psychosis; South-east Nigeria

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doi: 10.4102/sajpsychiatry.v24i0.1109