Factors Associated with Homicides in Psychiatric Expertise in Togo

Background: In most societies, homicide or murder is a crime that often leads to imprisonment. Studies around the world have sometimes found cases of mental illness (schizophrenia spectrum disorders) as an explanation for some homicides. The aim of this study was to determine the factors associated with homicide in the Togolese context. Methods: This was a descriptive and analytical cross-sectional study of pre-trial psychiatric expertise reports from January 31st, 2019 to January 30th, 2022. Results: Out of 704 defendants appraised, 206 (29.3%) had committed homicide. Males accounted for 91.7% of Homicide defendants (HD). Their average age was 31.6 ± 12.2 years, with extremes of 16 and 74 years. Factors associated with homicide were female gender, age between 30 and 45 years, married or cohabiting status and occupation as a farmer/fisherman/breeder. Psychoactive substance use (PAS), mental illness and psychiatric history were not associated with homicide. Conclusion: Preventing delinquency and interpersonal conflict, and promoting social cohesion, could significantly reduce homicides in Togo.

Profile of Forensic State Patients Admitted to ZébéPsychiatric Hospital (Togo)

Introduction: Zébé Psychiatric Hospital is the only psychiatric hospital able to receive forensic mentally ill patients in Togo. The aim of this study was to describe the socio-demographic, clinical and forensic aspects of forensic mentally ill patients. Method: This was a descriptive cross-sectional study conducted from August 16th to September 16th, 2021 among forensic patients admitted to the Zébé Psychiatric Hospital. Results: During the study period, we recorded 28 forensic mentally ill patients. Fifty-seven point one percent (57.1%) of the forensic patients came from rural areas. The mean age of these patients was 37.3 years, and ranged from 13 to 82 years. Males predominated in 96.4% of cases. Primary education represented 39.3% of cases. Single people predominated in 92.9% of cases. They were unemployed in 64.3% of cases. Forty-six point four percent (46.4%) of these patients were using at least one psychoactive substance. Forensic offenses were dominated by murder in 53.6% of cases. The victim was a family member in 53.6% of cases and male in 60.7% of cases. They had schizophrenia spectrum disorders in 78.6% of the cases. Forty-six point four percent (46.4%) of these patients were not responsible for their offences and 82.1% were abandoned by their families. Conclusion: The information gathered in this study will help to better organize strategies for mental health promotion and prevention of mental illness and crime in the general population.

Epidemiological, Clinical and Therapeutic Aspects of Schizoaffective Disorder at the CHU-Campus of Lomé(Togo)

Introduction: Schizoaffective disorder is a chronic psychotic disorder. It is characterized by the simultaneous presence of symptoms of a characterized mood disorder and symptoms of schizophrenia. Data on this disorder are almost non-existent in West Africa. The objective was to describe the epidemiological, clinical and therapeutic aspects of schizoaffective disorder at the Campus University Hospital Centre (CHU-Campus) of Lomé in Togo. Framework and Method: This was a retrospective study with a descriptive aim on patients hospitalized at the Clinic of Psychiatry and Medical Psychology (CPPM) of CHU-Campus from January 1st, 2013 to December 31, 2018. Results: A total of 46 patients were included in this study. Their mean age was 39.5 years with extremes ranging from 14 to 65 years. Females had predominated at 52.18% or a sex ratio of 0.91. Married people represented 47.83%. Primary education represented 34.80%. The unemployed were in the majority at 32.92%. Sixty-five point twenty two percent (65.22%) of the patients had a personal psychiatric history. All patients had presented with delusions plus other psychotic and mood symptoms. Almost all patients (97.82%) had received a thymoregulator associated with a first generation antipsychotic (95.65%). Conclusion: More studies should be done in our countries to describe the cultural aspects of this disease.

Characteristics of Heroin Users in Lomé(Togo)

Introduction: Opioid use is a public health problem today. The aim of this study was to describe the socio-demographic characteristics, judicial aspects, addictive behaviours and medical aspects of heroin users placed on methadone (HUM) at the Integrated Addiction Care Centre of Kodjoviakopé (CEPIAK). Framework and Method: This was a descriptive cross-sectional study conducted at the CEPIAK in Lomé, Togo, from December 1st, 2020 to January 31, 2021. Results: A total of 200 HUM were included in this study. They were Togolese in 89.0% of cases. Their mean age was 43.4 ± 9.6 years with extremes ranging from 16 to 66 years. Males accounted for 90.5% of the HUM, i.e. a sex ratio of 9.5. Primary education accounted for 39.0% of cases. Single people accounted for 44.0% of cases. One hundred and nineteen HUM (59.5%) had a history of incarceration. Cannabis, tobacco and cocaine were the other drugs associated with heroin use in 79.5%, 74.5% and 59.5% of cases respectively. A history of overdose accounted for 18.0% of the HUM in our sample. Suicide attempts accounted for 19.5% of the HUM. Tuberculosis was detected in 5.5% of the HUM. HIV accounted for 3.0% of the HUM. Conclusion: It is important for the Togolese health system to give more importance to this issue, which is shared by the medical and social sectors, in order to effectively reduce and prevent these social ills.