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Friday, 14 August 2015

THIS STUDY IS A DESCRIPTIVE RESEARCH WORK CARRIED OUT IN OKA-AKOKO SOUTHWEST LOCAL GOVERNMENT IN ONDO STATE, IT IS BASED ON THE SOCIO-CULTURE CAUSES AND MANAGEMENT OF PSYCHOSIS AMONG YOUTH IN THE ABOVE NAMED COMMUNITY.





CHAPTER ONE
1.0    INTRODUCTION
        This is a research work prepared on one of the mental illness known as psychosis precipitated by socio cultural tendency as a societal belief. It is established by the World Health Organization that health is every important the life of an individual.
     Therefore, “HEALTH” is defined by the World Health Organization (WHO) as the state of complete physical, mental, and social well being of an individual and not merely in the absence of disease or infirmity.
      Where the mind and the body were functioning very well which means the state of health such particular person is mentally sound and he/she is fit to perform or carrying out any function or assignment in a giving society in another development one can also be said to be deviated from social values when the state of health is not mentally sound which means that both the mind and the body has been scattered
    Because anything that affect mind and body will surely affect the personality of such individuals. The world psychosis is as old as spam itself on earth because mental illness which comprises of various class such as schizophrenia, hemephitic, catatonic, paranoid undiffential, bipolar affection disorder, hypomania, mania respectively psychosis is a major form of mental illness that need proper medical management because of it “SPORT” in personality characterized by hallucination, delusion, irrational behaviors taught broad case and taught insertion e.t.c.


      These are the real signs and symptoms that differentiate the major of mental illness from minor types of mental illness. The minor mental responded quickly to treatment even some may not need admission before the patient hack to convalescent such as anxiety, neurosis, obsessive compulsive neurosis, phobia e.t.c mental illness is our society believe as been attributed to many thing such as course (“EPE”) spiritual attack demonic devil e.t.c. due to their own believed or what oracle has been attributed to them
         But mental illness has a lot of cause medically both preceptors any predisposing factor some may occur as a result of accident lead to injury, typhoid fever resulted in to typhoid psychosis e.t.c. other cause including Indian Hemp (IGBO) heroin, cocaine of mental illness one to deprivation of some nutrient that the body need for development in which some culture disallowed an individual from taking it such eating snail by the pregnancy women prohibited some meat even food e.t.c.
       All this are baboons and many others that we can not mention in this write up constituted hazard to man development. The socio-cultural behaved of our society contributed immensely to the occurrence of mental illness in our society.
         Lastly psychosis is a major form of mental illness which advance to chronic state leading to admission in a well established hospital for proper management in order not to cause a lot of hazard to the society so it is the obligation of every health worker who found him/her self in field of mental to the vigilant constantly for unexpected behavior of or causing condition and other factor or to the effectiveness of particular method of care.

1.1            BACKGROUND TO THE STUDY
History of Oka-Akoko township and all the village surrounding including, Iwaro, Okia, Akungba, of Akoko land before the new geopolitical division of Nigeria was formed, Oka-Akoko is one of the oldest “YORUBA” land who delivered the people of Iwaro during the great war and later he establish his own habitation which gradually developed become Akoko township today.
     The town of Ako-Akoko was located at 75 Kilometre south, the south west of Ondo state (Akure) the present capital of Ondo state rainfall in the area last for a period of three to six months, this explain how the crops annually produced it was founded that traditional festivals are being practices in Oka-Akoko town, such as Egungun, Oro e.t.c. these festival areas still practice till this present time.
       Furthermore, due to lack of document sources, the exact date of establishing Oka-Akoko is unknown but it must have being some hundred years before the colonial masters, Oka-akoko land have one Local Government, Oka-Akoko South West Local Government, but the emphasis in this study is laid on Oka-akoko south west local government a study of the socio-cultural causes and management of psychosis also Oka-akoko comprises of different tribes and religion.
          ECONOMIC ACTIVITIES
         For many years after its establishment of the main occupation of Oka-Akoko people in hunting which is supplemental with farming and civil servant.
EDUCATION
        The educational background of the study area traced thus: -
I.            About 30 primary school
II.            About  16 secondary school
III.            One higher institution, Adekunle Ajasin Akungba-Akoko

RELIGION
            The people are very religious and there are three main religions groups, such as Christianity, Islamic and Idol worshipping. At a particular time in a year, they carried out some tradition and festival such as Egungun, Oro e.t.c
HEALTH FACILITY
There is health facility which was denoted by Oka-Akoko South West Local Government such as General Hospital, Ojo Ajoke community Health Centre
The people of Oka-akoko South West, benefit from Ojo-Ajoke, Iwaro market and other marker that cannot be mention
WATER SUPPLY
Oka-akoko South-West is supplied with pipe-bore water and during the dry season they depend on well and other borehole
LANGUAGE
There are many different language speaking people reside in Oka-akoko South West e.g. Yoruba, Igbo, Hausa e.t.c.
WATER MANAGEMENT
  The common method of refuse disposal in Local Government in sanitary open dumping which breeds and harbor pests. The people also defecate in the bush due to absence of latrine/ toilet/ accommodation.

1.2            STATEMENT OF THE PROBLEM
The problem that is associated with socio-cultural causes and management of psychosis among youth in Oka –Akoko metropolis. The rate at which socio-cultural causes are affecting the health standard of the people is very high
   By the following problems that are

1.     The pear group influence some youth physically or even the effect of the drug make some of them act out in a bad manner as a result of drugs.
2.     Another problem is poverty among the people due to unemployment malnutrition, overcrowding and also loss of  personal security
3.     Also drug, alcohol suicide are also part of the problem which affect socio-cultural of the people’s health

1.3            STUDY OBJECTIVES
1.     To identify main causes of mental illness among youths in Oka-akoko metropolis
2.     To eradicate social stigma or any forms of stigma attached to mental illness
3.     To counsel those who are already suffering from mental illness among youth in Oka-akoko metropolis.
4.     To enable the researcher to know the attitudes of the ward then care in case in control the control the socio-cultural effect to psychosis (illness)
5.     To help to know the cultural aspect that contribute to psychosis disease among the youth and how it can be control.
6.     To enable us to know the solution to the problem cause socio-cultural causes toward psychosis in control psychosis disease.

1.4            RESEARCH QUESTIONS
1          Does socio-cultural practices health delivery in your area?
2          Does the management of psychosis have effect on the health of the people suffering from the problem?
3          Does the effect of socio-cultural affect the health care delivery in your area?
4          Does the source of this problem can it be eradicate by anyway or any means?
5          What is the link between sleep disorders attention disorders?

1.5     DEFINITIONS OF TERMS
MENTAL HEALTH: - is a state of well being in which the individual realizes his/ her own abilities can cope with the normal stresses of life, can work productively and faithfully, and is able to make a contribution to his/ her community (W. H.O) 1948.

MENTAL ILLNESS: - is a medical condition that disrupts a person thinking, feeling, wood, ability to relate to others and daily functioning (NAMI). The National Alliance on Mental Illness (1999)
COMMUNITY MENTAL HEALTH: - can be defined as a branch of medicine that deals with prevention treatment diagnosis and to rehabilitating of mentally diagnosis sick patient in the community (Wikipedia/ Encyclopedia)
 DELUSION: - can be defined as false believe which cannot be share by people of the same race or culture (the free dictionary.com)
 SCHIZOPHRENIA: - is a major mental disorder which characterized to personal disorganization (John Nash 1987)
 PHYSICAL ILLNESS: - is any type of illness that affects body such as a virus, rash bacterial infection e.t.c. (Wikipedia Encyclopedia)
CATATONIC: - an abnormal condition variously characterized by stupor, stereotypy, mania, and either rigidity or extreme flexibility of the limbs it is most often associated with schizophrenia (Medical dictionary1999)

 NEUROSIS: - is a class of functional mental disorders involving distress but neither delusions nor hallucinations, where by behavior is not outside socially acceptable norms. (Wikipedia Encyclopedia)
PARANOID: - are those that have extremely to suspicious of other and characteristics by persecutory delusion (dictionary, encyclopedia and thesaurus the free dictionary)
ILLUSION: - is misinterpretation of an object or a person (Medical Dictionary)
 SOCIO: - a combining form used, with the meanings “social” “sociology “, or “society” in the formation of compound words. (Dictionary .com)
CULTURE: - is the quality in a person or society that arises from a concern for what is regarded as excellent in arts, letters, manner (Dictionary. Com)
SOCIO-CULTURAL: - is the relating to, or signifying the combination or interaction of social and cultural elements (Dictionary.com) google

CHAPTER TWO
2.0                            LITERATURE REVIEW
2.1    INTRODUCTION
        Mental illness was defined by the British “MENTAL HEALTH ACT” (1959) as arrested or incomplete development of mind, psychopathic disorder any other disorder or disability of mind. Mental illness and other abnormalities that present with predominantly or entirely psychological symptoms and disturbance of behavior J.L GISOM (1977) integrate clinical science.
       According to NAMI National alliance on Mental Illness (Google) defined mental illness as a medical condition that disrupts a person‘s thinking, feeling, mood, ability to related to other and daily functioning
        According to D.S Michael (1968) each of mental disorder is plan a clinically significant behavioral or psychological syndrome or pattern that occur in individual and that is typically associated with either a painful symptoms (distress) or impairment in one or more important area of functioning disabilities in addition, there is an inference that there is a behavior psychological or biological de-function on or abnormalities, and that the disturbance is not only in the relationship the individual and society which may serve as disturbance it may represent social deviance, that may be commendable or not be commendable but is not by itself  a mental disorder in ability to cope with the recent stressful situation and in ability to achieve relative adjustment to all situation, can bring about mental disorder AETIOLOGY OR CAUSES OF PSYCHOSIS AMONG YOUTH (MENTAL ILLNESS).

There are factor that could responsible before an individual breakdown and suffer with a mental disorder illness (psychosis). But the main focus are which is prevalence to the youth in my locality is socio-cultural causes other factor could either be the following.

2.2   HEREDITY, PSYCHOGENIC AND TAUMA SOCIAL-CULTURAL CAUSES OF PSYCHOSIS (MENTAL ILLNESS) SOCIAL ASPECT
          This could be result of peer group influence some youth are physical or psychologically depend a drug which without these drugs they affect of this drug some of them act out in a bad manner.
A.               DRUG: - taking an abusive drug such as (Marijuana) especially college student that they believe that marijuana help in studying most of their memory for thing that happened in the few minute hours or day become impaired.
B.                ALCOHOL: - this is toxic to the human body and as well the brain even to the liver that tries to break it down quickly and render it harmless. Because the level of blood determines the concentration of the poison that will go to the brain and other organ and probably some brain are less to levant to alcohol than other the more the concentration build up in brain the individual capacity utterances and behaviors becomes grossly impaired
SUICIDE: - most especially those that being dump, by their parent they are  depressed they feel unwanted and unsolved some neglected child in boarding school and never write them or visit them so they feel that no one understand or care to understand how they feel some youth had tried to hide their feelings for some month or years, sorrow, inferiority,  any loneliness by taking the drugs marijuana or alcohol they break down even some of them have experience of a great disappointment in love or their chosen carrier or in some essential completion or they have felt disgrace or blame thereby compelling them self thinking due to emotional in balance there will be inability to cope with the little or recent stressful situation and difficulties to adjust in the environment there by bringing about mental illness (psychosis)

     OTHER SOCIAL CAUSES OF PSYCHOSIS
Major mental illness includes the following: - poverty due to unemployment, malnutrition, overcrowding, loss of personal security, social derivation
CULTURAL ASPECT
Cultural it could be as a result of taboos belief and traditional of our olden days forefathers which serve as negative practices to the positive health and that if fail to accept it most often tend to inability to adjust in that particular locality
A.               TABOO: - this situation has become the habit of our fathers and mothers in the community, some of them say that a pregnancy into woman should not be taking snail, pork meat, which they contain all essential nutritive material that can make the body to be early intelligence.
B.               TRADITIONAL: - Experience is the best teacher there is a young man who wrote that he murdered his wife simply because he was ask to do some sacrifice by the leaders of their village which and fail to do so because is an educational personal and this is traditional believe of the village head the next day he was sleeping and heard strange voice because he could not understand what is going on already he has murdered his wife and since then we could not come to normal.

C.               BELIEVE: - believe of people could bring about mental illness especially in some areas where they said that a lady should not marry to a man of another places which when they frustrated this lady due to some problem been encountered by this lady she may become a mentally retarded person.

OTHER FACTOR ARE
   It has been understood that mental illness comes on in the family (i.e.) from one generation to another generation usually transferred through genes.
THE GENES: - this is the substance that carry the treat that bring transferred from the parent to their offspring e.g the pigmentation colour of the eyes they contains in the chromosome.
Genes can be transmitted from one generation to another unchanged or change by the process of mutation it is an established fact that the biochemistry of the body is being controlled and determined by genes and some of the mental illness such as depression may be due to underlying biochemical disturbances on the body.
TRAUMA: - any direct injury to the brain may bring about an attack of mental illness. Head injury such as convulsion, cerebra vascular accident, compression can precipitate mental illness 

PSYCHOGENIC FACTORS: - psychogenic as a factor responsible for psychosis in youth has to the individual subjective and emotional feel about him.
It include feeling self stream  security well being  personal value guilty and firmly when an individual must cope with the situation that less negative feeling about himself , his anxiety level raises and inter psychiatric stress failure to related positively within the society lack of self confident in security.

Emotional ma-adjustment from early life experience conflict from erratic nagging matter  prolong separation psychological regretting parental friction, in consistence in child management over-protection, loss of beloved one, loss of title
     Academic pressure, vocational pressure, marital stress may precipitate mental in balance in youth.

     GENERALLY MENTAL ILLNESS IS BEING CLASSIFIED INTO SUB BROAD HEADING WHICH INCLUDE
1.                 PSYCHOSIS
2.                 NEUROSIS
3.                 PERSONALITY DISORDER
4.                 MENTALLY SUB NORMALITY
5.                 PSYCHOSOMATIC DISORDER
6.                 DRUG
AMONG THE ABOVE CLASSES OF PSYCHOSIS IS MORE PREVALENCE TO THE YOUTH IN OKA-AKOKO METHODOLOGY ONDO STATE.
PSYCHOSIS: it is the major mental illness because it is a severe type of mental disorder in which a drastic change in patient personality occurs.
          The disturbance is likely to involve aspect of mental function i.e. feeling, thinking, any perceiving patient fail appreciate the real word in a normal manner.
PSYCHOSIS CAN BE SUB-DIVIDE INTO TWO
1.       FUNCTIONAL PSYCHOSIS AND
2.       ORGANIC PSYCHOSIS


FUNCTION PSYCHOSIS: is a serious mental illness that is not funded on physical disease or any known kind. It is of course possible that facture research way show this group of illness to be associated with a biochemical disturbance with in the brain calls indeed recent investigation have strongly indicated like hood of such a biochemical factors in sowed functional psychosis.
EXAMPLES OF FUNCTIONAL PSYCHOSIS WHICH INCLUDE
1.       MANIA
2.       DEPRESSION
3.       SCHIZOPHRENIA
4.       MANIC DEPRESSIVE PSYCHOSIS

2.3    MANIA: it is an affective mental disorder characterized by evaluation of mood, rapid, thought and speech, entrance over activity and irresponsible behaviors.

           TYPES OF MANIA
Mania relation are characterized by various degree of evaluation and psychomotor over activity there are 3 degree commonly described denoting the progression of  behavior ranging from mild to extreme or from degree of manic psychosis is through these reaction differ in degree than kind thus it merit separate consideration in term of management.

1.                 HYPOMANIA: this is the mildest from of manic reaction and it is characterized by moderate evaluation, fightiness and over activity. This patient will always say that he/she as never felt better or happier in his/her life. He/she has unbounded confidence in his ability, knowledge any he will hesitatingly express his opinion on anything he has speed up in thing and become entertaining be seen tired less and get practically no sleep, starting that he feels well that we close not need anything during the day he engage himself in countless activities e.g. talking, visiting, and other thing telephoning working on various appointment chanced and post pones some the mails frequently seen slow to these individual and they tend to send telegram and speed post of make telephone call to more distance place his overall picture usually appear at first to be one of aggressive nest brilliant and sociable individual who has commendable enthusiasm and wonderful plan for the future initially he feature an exciting person to be with but the reveal his self cantered-ness, soonest, thus he become domineering monopolies he conversation and exhibiting difficulty in sticking the subject this individual can tolerant critics and may without hesitancy make fool out of  anyone who are to disgrace with him or interfere with his plan the detail of this individual easily rationalize his activities and concede this.
2.     ACUTE MANIA: The symptoms in acute mania are similar to those of hypomania but are more pronounced. The condition may develop out of a hypomania state or any develop suddenly with little or no warning restlessness station and pressure of activities become more pronounced any he may laugh boisterously and many talk at top voice. 

 He become increasing boastful authoritative and many other people around his as if he were their superior irritability he is easily provoked and his mood may change rapidly from quiet to anger both before and after hospitalization violent behavior is common and the individual may break undergo demanding release by walling back and forth gesturing himself, singing banging in the wall and door ever person who have had the most rigid moral back ground will show a complete abandonment of moral restraint and way be obscure in their talk expose themselves and make sexual advances to those around them there is a mild fight of idea frequently leading to incoherent speech, the attraction in ideas may be as rapid that or a moment the person may engage in one erratic activities to the next delivering a profound religion dissertation  there may be some confusion and disorientation for time place and person with a tendency impossible to converse he evidence the most extreme psychomotor over activity.
3.     DELIRIOUS MANIA: in most severe type of manic reaction the individual is confused, widely, excited and evident. The condition may develop out of hypomania or acute mania but more frequently appear suddenly and with very few warning signs. The individual is incoherency and severely disoriented. Vivid auditory and usual hallucination it is impossible to converse with him or told his attention he evidence the most extreme psychomotor over activity violent and destruction and spend his days and night in restlessness spacing, singing, screaming gesticulation any incoherent shouting. His eye may show a peculiar glare and his feature may contoured beyond recognition one moment he may refuse food and the next devour everything he can get hold of his behavior is absence and entirely shameless and personal habit completely deteriorate   


he is dangerous to those about him and seriously injured himself in short he fitful the popular nation of varying mania.
          This condition places a tremendous burden on all bodily function and the potent losses weight rapidly and may become evenly exhausted as might he expected, value ability to hear attack and stroke is increased and also resistance to infection in lowered particularly among other patient fortunately the degree of excitement in manic reaction can now be markedly reduced by means of various drug often in combination with election – shock and scene such as this no longer occurs.
CAUSES OF AETIOLOGY
This can be discussed under two sub heading predisposing and precipitation factors.
1. PREDISPOSING FACTOR: they can otherwise be called intrinsic factors are:-
i. HEREDITARY:  -though the mode genetic inheritance is not clear. It has been show that it is prevalent in first degree relative it has also been established that it is more common in monozygotic twin than dizygotin twin.
ii. PHYSICAL: - it is more common in people of pytanic body build i.e. short extremities short neck and rounded cavity.
iii. PREMORBID PRESONALITY: - bipolar is more common in cyclothynic individual while unipolar is more common in extroverted individual.
2.PRECIPITATING FACTOR: - It is otherwise referred to as extrinsic or external factor and it include.
I. EMOTIONAL FACTOR: - frustration, disappointment sudden wealth promotion.
ii. CHEMICAL FACTOR: - Drug like indian temphetamine occaine can cause increase dopamine activities.
iii. INCIDENCE: -The ration of incidence is about 85% in monozygotic twin / identical twins / it is more common in male than female.

2.4     PSYCHOPATHOLOGY OF MANIA
       Mania is defined as affective disorder which characterizes feature of mood disturbance toward election and optimism mood itself is a prolonged emotion that alters the following permanently can be used.
Threshold duration intensity and appropriate. Threshold is often referred to as a part of which a sensation is felt which can either be lower high.
 In this morbid state threshold is low and that explaining their excitability.
DURATION: - Of manic Illness is often changeable and in this cause their mood to be table intensity every individual has period when he become low or high and behaviour dominated the patient life as in manic patient who is deviated.
APPROPRIATENESS: - The emotion of a manic patient is often appropriateness effect of a popular caonicaltive or hebephrenic, schizophranic. It is in the basic of the above mentioned parametal that all these manifestation accompanies manic illness.
CLINIC MANIFESTATION: - Increase psychomotor activities election over confidence, fight of idea, insomnia, impaired concentration, irritability, intolerance in chronic manic.

DEPRESSION: - Depression is a pathological disturbance of mood toward sadness and pessimism. It is commonest mental illness needing special attention (community mental health by comrade Mustapha Abdullahi “depression is also known as psychomotor retardation where there is mental slowness of activities” Psychiatry and nursing practice by D.A Jaiye Oba(1980).
OCCURRENCE: - Age incidence vies with increase in age, sex, more common in woman than man.

TYPES OF DEPRESSION
1.                       Reactive / Exogenous depression
2.                       Endogenous / primary depression
3.                       Secondary depression.
REACTIVE DEPRESSION:- is initiated by very disturbing event in the patients environment these external factor can be many and various, but usually they entail some definite loss or a considerable unrest to the individual well established way of life.
A reactive depression some time occurs in a person who was always over sensitive or frantly neurotic anxiety and irritability are often present in reactive depression.
ENDOGENOUS DEPRESSION: - by contrast seems to arise for more apparent reason or in response to rather minor external event it would appear to be related more to internal or constitutional factor.



SECONDARY DEPRESSION: - this secondary type because it is a sort of depression that linked with physiological change in the body for example menopausal syndrome, old age, and cursing syndrome.

CLINICAL FEATURES
1.     PHYSHOLOGICAL:- (a) patient look sad and tired (b) loss of interest (c)loss of vitality (d)with drawn everything seem, gloomy and hope less anxiety and tension motor retardation speech “slow and monotonous poverty of thought” and movement, slow lack of concentration feeling of guilt delusion hypochonlye serve punishment, hallucination rare.

2.     PHYSICAL: - insomnia, anorexia, loss of weight, constipation, indigestion, loss of libido and dryness of month. Tight feeling on the chest palpation giddiness amenorrhoea.  In female depressive stupor progressive retardation and respond to stimuli neither take on feed nor answer question.

3.     MANIC DEPRESSION PSYCHOSIS
3.6Is one of the two so called functional psychosis and is a major or psychotic scourge in that it is responsible for more admission to mental hospital than  any other condition expect schizophrenia “and the organic deterioration (an introduction to psychiatry by D Curran Teal (1972). In its classically by developing of different time but in the patient of sustained and contrasting disturbance of mood excitement and depression it is therefore, one of the 50 called affective disorder.


4.     MANAGEMENT OF PSYCHOSIS
5.     As well know that psychosis is a very severe mental illness which involve other, disorder for instant mania, hypomania, schizophrenia, manic depressive psychosis and soon for this the management is going to be unlike other cases.
1.     ORGANIC THERAPIES: - the organic or physical methods of treatment of psychiatric disorder. Include the use of drug and electro-convulsive therapy and psychosurgery.
2.     NEUROLEPTIC:- it is also known as major tranquilizer, this were introduced in the 1950 and have been very significant in modern psychiatric treatment of patient suffering from psychosis largely because of  neuroleptico many people who would otherwise be indefinitely confined to the ward of psychiatric hospital are able to leave happy and useful lives in the community narcoleptic exert anti-anxiety and anti-psychotic effect, they cause marked sedation, without necessary including sleep and are effectively in patient suffering from the most server agitation and excitement they cause gradual disappearance of symptom in most cases of acute and chronic psychosis.
3.     TRANQUILIZER: - Are drug used in treatment of severe psychiatry disorder it is divided into two major part minor tranquilizers have a calming effect with comparatively low level of sedation. They are also used in the short term in acute condition states it is also reduce aggression and tension, control delusion, hallucination through disturbances and major over activity without clouding consciousness.

          THESE DRUGS INCLUDE:
I        CHLORPROMAZINE (LARGACTIL)
Dosage 75mgs 800mgs daily and in divided doses may be given intramuscular or intravenously it is present in tablet of 25mg, and 50mg daily may be given to psychotic patient.
ACTION: -              Largactil produce calmness, reduce tension and aggression and modifies behavior
II       THORIDAZINE(MELLERILL)
Dose 30-60mg orally in divided dose popular for the elderly in confessional state.
ACTION:-it same as largactil
Diazepam (valium)
Dosage 10mg intravenously.
Paraldehyde and thiopentone may also be useful treatment of status epithetic.

          TREATMENT OF GENERALIZED SEIZURE
A.                  Epithemeron sodium copsnanutin nilatin dosage 100mg – 400mg daily in divided dose side  effect gastro – intestinal disturbances, a – taxia, skin rashes, gum hypertrophy.
B.                  Phenobarbitone:- dosage 100mg – 300mg daily divided doses, side effect, skin rashes, ataxia, drowsiness, restlessness, agitation may prevail in other individual.
C.                  PPIMIDONE :-  (Mysolin) dosage 500mg – 1.5mg they in divided dose side effect: - as in phenobarbitone. 



D.                  CARBAMAZEPINE (Teqiretol) dosage 400mg – 1600mg daily in divided dose side effect, gastro intestinal disturbance, drowsiness and rasties, it is used in psychomotor and focal epilepsy more so electro-convulsive therapy was used in treating schizophrenia.
E.                   INDICATION: - the major indications for the use F.C.T are psychotic depression and schizophrenia especially the catatonic type F.C.T is also used to treat mania. Technique of administering electroconvulsive therapy, in the standing technique electrode is applied to both temples, skin resistance being decreased by solution. The patient position on the bed to avoid injury.

THERE IS TWO WAY OF ADMINITERING F.C.T.
1.                       The modified method.
2.                       Unmodified method.
MODIFIED TYPE OF ELETRO-CONVULSIVE THERAPY 0.06MG
Atropine is give intramuscularly gradually before the anesthetic such as suxameth onium chloride (scoline) during treatment the patient is oxygenated. An anesthetic is present during treatment and recovery.

          UNMODIFIED METHOD: - this is usually the only available method in development countries because of the shortage of anesthetic. In this method the patient is places on a bed and covered with a bed sheet is held on either side by attendant or nurse. The sheet is pulled to restoration the patient is soon as the jerking movement and prevents fracture or other injury.



          SIDE EFFECT: - on modified F.C.T Broncho spasm, circulatory, collapse and cardiac arrest.
 Unmodified:-confusion, excitement, memory, impaired however, detail management of psychosis will be wild for the write up there by limiting the management in this little form. ACCORDING TO PSYCHOLOGICAL MEDINE BOOKS: AN INTRODUCTION TO PSYCHIATRY BY: D. CURRAN, M. PATRIAGE AND P. STOREY. Explain the etiology bipolar manic depressive psychosis has a clear out hereditary element and tends to breed true the constitution basis of severe depression of endogenous pattern is also are well established, for example about 70 present of monozygotic twins are concordant for depression compare to about 25% of same second dizygotic twins. The mode of transmission is uncertain, except that where may be autosmal dominant genes of complete pen truce or in heritance may be polygenic.

                   AS TO PHYSICAL FACTOR.
         Attack may be precipitated by severe infections, especially influence any infective hepatitis they have also known to follow strokes and head injuries and to occur in causes of parking sonism and sequal to encephalitis ethergic among other condition that affects the central nervous system.
PRECIPITATING FACTOR: - such as misfortune or other stressful incident e.g intense frustration as when there has been failure to found a suitable job despite strenuously.
Persistent effort or when determined attempt to carry through reformer presently threatened by retake can be a precipitating factor of manic depressive psychosis.

 

2.5   SCHIZOPHERNIA: - schizophrenia is a severe mental illness predominantly of young people it tends to be a chronic illness has pervasive effect on the personality which affect the ability to relate to others, causes disturbed mood, impaired perception and disturb through processes. Schizophrenia was originally called dementias praeox by kraeprlin (the German psychiatry 1856-1926) because it occurred mostly in young people and tended to cause progressive deterioration of the personality owning to the recent advance in the treatment of schizophrenia, we no longer hold such a bleak of the likely outcome of the illness.

AETIOLOGY: - according to psychiatry for the (Health Profession R.O JEGEDE) explain that although the causes of schizophrenia are not fully understood. There is now considerable about contributory factor these are discussing below:-

HEREDITARY: - It is now widely accepted that genetic factor does plan an important role in the transmission of schizophrenia. The risk of schizophrenia in the general population is 0.85 percent this figure rises the more closely a person is related by birth to a known schizophrenia a higher if his or her brother is schizophrenia than if his or her cousin is some of our knowledge of the role of heredity in the etiology of schizophrenia come from studies of monozygotic(also known as identical and dizygotic (also known as “fraternal’’  twins monozygotic twins originates from a single  ovum and so they have similar set of genes and similar genotype.(i.e. overt characteristics) dizygotic twins originate from two has confirmed that monozygotic twins originate from two different ova.

Observation of large number of twins has confirmed that monozygotic twins are more expect to developing schizophrenia than dizygotic twins however, the fact that member of monozygotic twins pairs do not have 100% concordance rate with respect to schizophrenia suggest that non genetic factor may also be etiological significance.

BIOCHEMICAL FACTORS
There is considerable but inconclusive evidence that disorder able biochemical process in the body are associated with schizophrenia for this is (a) the deranges biochemistry observed in many schizophrenia and (b) the observation that the ingestion of certain chemical such as lysergic acid diethyl amide (L.S.D) can produce as psychotic illness which closely resemble schizophrenia India hemp (can nab is sativa) has been known to cause a psychotic illness which is almost in distinguishable from schizophrenia it remain to be proved whether the biochemical disorder  that is observed in schizophrenia is a cause or an effect of the illness.
ENVIRONMENTAL FACTOR: -
According to psychiatry for the health profession (R.O JEDEGE) state that there is a higher incidence of schizophrenia in the lowest classes, so it has been postulated that social class of etiology significant however, it is now be that their illness cause schizophrenia to drift down word into the lower social classes. It has been suggested that disturbance in the relationship within the family (both between mother and father and between parent and children) contribute to the onset of schizophrenia in children stressful life event may proceed an attack or a release, however a stressful life event or any other single factor is not a lone sufficient to cause schizophrenia.
GENETIC AND ENVIRIONMENTAL FAXCTO PSYCHOPATHOLOGY
    In the book he further explain the genetic factor in the etiology of schizophrenia that the well known observation that the major psychosis, schizophrenia and manic depressive illness tend to show a familiar distribution has led many investigation to assume the importance of  hereditary factor in their etiology. Although other have attempted to explain the phenomenon in tern of familiar rearing and acculturation
The role of hereditary has been reinforced not only by studies on twins but by recent studies employing adoption to separate the genetic and environmental influence. In addition the later studies has opened the way to new research aimed at the identify of etiologically important genes.
       Molecular genetics techniques are being used without notable success to date in a search for linkage between give mental disorder and chromosome region in pedigrees with multiple instance of the disorder.
BRAIN TRAUMA: - individual with brain damage especially if it affects the temporal region many develop symptom of schizophrenia. The role of trauma in the etiology of schizophrenia is a clear
PREMORBID PERSONALITY: - the premiered personality of the schizophrenia patient is free frequently schizoid. It is characterized by suspiciousness, inability to tolerate or maintain close inter personal relationship shyness, with draw, and some degree of eccentricity.
      The aetiology of schizophrenia is far from it appearing that multiple factor rather isolated one or important on the genesis of this illness none genetically determined susceptibility.
TYPE OF SCHIZOPHRENIA: - The major types of schizophrenia are
a.                 Simple schizophrenia
b.                 Hebephrenic schizophrenia
c.                  Catatonic   schizophrenia
d.                 Paranoid schizophrenia
a.     SIMPLE SCHIZOPHRENIA: - the onset of simple schizophrenia is show any gradual the affect person show abnormalities of behavior and is increase unable to meet social obligation eventually he /she become self absorted and aimless and at this point may become one of the vagrant psychotic those unfortunate people who roam the street and the high ways of in developing countries delusion and hallucination tend to be other types. In addition simple schizophrenia is usually affecting individual between ten to sixteen years.


b.     HEBEPHRENIC SCHIZOPHRENIA: - in hebephrenic schizophrenia affective abnormalities including in appropriate and shallow affect and sully giggling are prominent, in addition though disorder, delusion and hallucination occur behavior to be unpredictable and irresponsible and in annerism are common. Hebephrenic schizophrenia patient always beat the age of twenty and twenty one (20-21) he be mean youth that is market place, banks, post office e.t.c.
c.      CATATONIC SCHIZOPHRENIA: - as mentioned earlier, psychomotor disturbance and prominent feature of schizophrenia   and the affected patient many alternate between motor restlessness. They later may be accompanied by unprovoked aggression and destructiveness. Other symptoms include automatic obedience in which the patient does everything he/she refuse to carry out instruction and may indeed to the opposite “WAXY FLEXIBILITY” is a characteristic of catatonic schizophrenia, if the patient limb are placed by the examiner in one position, they will be kept in that position even if it is uncomfortable for a long period of time.
2.     PARANOID SCHIZOPHRENIA: - the major characteristic of paranoid schizophrenia is the occurrence of delusion which are usually persecutory but which may assume other form, such as delousing bodily or exacted birth.
3.     Auditory hallucination may occur “in addition “this type affect age mostly between twenty five to forty years of age. It is very common in fairly old people.
4.     Incidence: - W.H.O now latter, on mental health state that about 45 million person worldwide above age 18 suffer from schizophrenia at some point in their live it being at giving age and can impair functioning causing the loss of an acquired abilities

CLINICAL MANIFESTATION
The clinical manifestation of schizophrenia is many and varied. They can best be described under five heading
      I.             Through disorder
   II.              Emotional disorder
III.              Perceptual disorder
IV.            Disorder of movement and behavior
   V.            Loss of contact with reality

Through disorder: - is one of the major manifestations of schizophrenia as a result of schizophrenia speech may be bizarre or incoherent.
The disturbance off through consist of:
a.                 Looseness of association (i.e. loss of weight connection between various ideals)
b.                 Important of abstract thinking
c.                  A tendency of existence use of symbol
d.                 Through insertion
e.                  Through broadcast
Emotional disorder: - schizophrenia illness has devasting effect on the emotions.
Emotion response are blunted i.e. responses to emotionally arousing experience are reduced or even completely eliminated, in addition to this schizophrenia may show in appropriate emotional reaction for example they respond to sad new by lamping a third kind of emotional disorder called labile affect may also occur patient with this disorder have unpredictable emotional disorder.
Perceptual disorder: - schizophrenia often has auditory hallucination. These may take the form of “voice” speaking to the patient or taking about him in either case, the content may be derogatory they also takes the form of command, instructing the patient to engage in bizarre behavior such as running out maker into the street or displaying unprovoked aggression usual hallucination, for example seeing spirit are less common than auditory hallucination.
Hallucination may be so troublesome or persistent that the patient becomes preoccupied with them, looking little or no time for anything else

DISORDER OF MOVEMENT AND BEHAVIOUR: - a variety of types disturbed psychomotor behavior occur in schizophrenia such disturbance are most pronounced in catatonic schizophrenia
At one extreme is reduced activity, characterized by a general with drawl from the patients’ customary daily activity.


The patient may keep to him or herself stating alone in a room most of the time and he or she may neglect of personal hygiene in catatonic patient, this reduction in activity leads to stupor and can maintain in comfortable or oven painful position for long period of times.
Alternatively, the patient may become excursively actives. The behaviors and most evident in the violent destructives aggressive out birst of the excited catatonic patient.

Loss of contact with reality-: in important characteristic of most schizophrenia is the loss of ago boundaries a phenomenon in which the patient loses of sense of where his person and the outer word begin. This condition result in delusion of thought are his own but are in sorted into his mind by others who are there by which the patients feels that his or her thought are begin broadcast or spoken out so that they are known to others may occur there may also be delusion of thought with drawl in which the patient feel that his or her thought are begin stolen. Loss of ago boundaries also leaned to loss of identity and the patient may doubt who he or she is or be in certain about his or her sex finally the patient may experience the sensation of thing appearing to be unreal (serialization)

ORGANIC PSYCHOSIS 
This is applied to mental disturbance which arise as a result of dateable physical corgenic / disease usually this inorganic condition affect the brain in a small number of cases however, there is a disease of another organ which lead to psychiatric disturbance. Brain function are impaired either lesion tumors infection or toxics e.g. epilepsy b. head injury c. cerebral anoxic, intoxication with     barbiturate amphetamine, phemobaro , tone hemp, alcohol e.t.c
Senile dementia as a result of the hardening of the middle layer of the blood vessel tunica media is also another major example of organic psychosis
Psychosis namely:-
A rapidly a cute type delirium
A slowly developing chronic type dementia


 DELIRIUM: -this is the type of illness usually occur as a sudden development in the course of an already existing disorder, usually physical in a nature.
Delirium or tonic confessional psychosis is readily noticeable. There is a little change of missing this condition in view of the associated irrational behavior on confusion in a typical delirium the patient is in a dream like or might marsh state of altered consciousness. It is difficult to engage his intention. He is apprehensive restless, shaking or actually terrified he may believe that his persecutor and under the bed or outside the window. The patient usually shows evidence of general or toxic disturbance e.g. perspiration finished face increased pulse rate, perhaps fever e.t.c.
The patient become disoriented as to time and place his memory for recent event is clouded visual and auditory hallucination may present it is sleep is disturbed he lack insight into his condition delusion usually present his mood is one of panic anxiety or irritability.
DEMENTIA: - this condition sometime known as chronic brain syndrome is the result of decline of mental function due to brain diseases or damage. The active clinical picture will depend up the speed and duration of the brain condition its severity and the part of the brain affected and also open the patient psychological make up most dementia occur after the age of fifty five years and in some youth a typical example is the mental deterioration which sometime occur in the elderly (senile dementia). Some dementia especially alcoholics commences with an episodes of a cute confusion usually, however the condition involved very slowly and is hardly forget and initiative the sight is poor, he may misidentify people in his immediate vicinity. Some of the cause of dementia and degeneration of nerve cells. Hardening of the cerebral blood vessel damage to nerve cell, due to head injury, brain tumor, and chronic alcoholism. Syphilis of the central nervous system (general paresis) e.t.c

1.6   EPILEPSY: - Epilepsy is characterized by abnormally were discharge in a conducting nervous tissue between cerebral cortex and mid brain with chronically recurring disturbance if consciousness “hands out on community mental health by (M. Abdullah Akanbi ) ( T. Asuni, F. Schoenbery and C. Swoft1994).
         Mental health and diseases in Africa in its book wrote that epilepsy is both a symptom and a disease. A symptom epileptic seizure point to inter crania pathology. As disease epilepsy is called idiopathic meaning that the cause is unknown in this discussion seizure conclusion and fit are used interchangeably. In all epilepsy seizure itself are caused by electronic discharge of a group of neuron, which may spread to other neighboring structure.
Symptomatic epilepsy may be the result of brain damage, trauma, infection, tumor, and toxin or as a result of disease elsewhere in the body.

AETIOLOGY
T. Asunni etal (1994) mental health and disease in Afica.
There appear to be a (1) generic factor involved in idio pathic epilepsy. A child with one parent with illness than do children who parent is free of epilepsy.

PRECIPITATING
A specific seizure in an individual who has been known to have epilepsy and who has been taking anticonvulsant medicine are:
Systematically disease associated with
1.                 Pyrexia 2. Excessive fatigue 3. Fluid retardation as in the premenstrual period 4. Hyperventilation

PSYCHOTIC FACTOR
Frustration, anxiety, depression and other certain phonic stimulation including a flicking television picture.


Other cause include
Infection, intra cranial mass, tuberculoma, cerebro-vascular insufficient, protein deficiency. These are determining in Senegal by the column and associate.

INCIDENCE
    The incidence of epileptic fit is between four eight per thousand epileptic fit is common seen in infancy childhood and adolescence it is seen or occurred in both men and women.

SIMPLIFIED CLASSIFICATION OF EPILEPSY IN ACCORDANCE WITH THE 1989 REVISED NATION
T. Asunni, F. Schoenberg and c. swift 1994 mental health and disease in Africa, classified epilepsy as follow

A.               GENERALIZED EPILEPSY
Primary or generalized epilepsy
Absence epilepsy, (petitmal), myoclonic epilepsy, gradual epilepsy, in futile spasm, lexongas syndrome.

B.               Partial epilepsy
v    Idiopathic partial epilepsies
v    Being epilepsies of childhood symptomatic cryogenic epilepsies
Temporal lobe occipital lobe partial lobe
Generalized epilepsies: -it can be classified into grandma absence and myoclonic epilepsies
GRANDMAL: -is the commonest type of generalized epilepsy by tonic colonic seizure
THE TONIC PHASE: - is initiated by sudden loss of conscious falling, a tonic spasm of all musculature resulting in hypertension and often accompanied by acryl as air is force through the tent vocal card. It last several second


CLONIC PHASE: - there is alternating compaction and relation of all body musculature during this phase that urinating in continence often occur and more rarely, facial incontinence frothy saliva sometimes blood stained if the tongue or lip is have been bitten it last between thirty and ninety seconds usually the patients complain of headache for several hour purpose behavior and over bizarre deep sleep to two hour up on looking the patient is often confused for new minutes.
ABSENCE (PETITMA): - seizure is characterized by brief loss of awareness it last for as long as a minutes the patient does not fall and unaware of the attack eyelid flicking rarely there is urinary in continence.
C.               PARTAIL EPILEPSY: - Partial epilepsy suggestion organic focus if tingling and other paraesthasias as in the body area governed by the sensory cortical focus.
D.               TEMPORAL LOBE (PSYCHOMOTOR):- epilepsy the symptom include autonomous nervous system phenomena finishing sweating and gastric sensation absence of contact with surrounding and confused behavior perceptual disorder including illusion or hallucination chewing of smoking, memory disorder amnesia or dajaru of jamazisuu and all other abnormal behavior during psychomotor episode are purpose less activity bizarre action assertive behavior.
STATUS EPILETICUS: - is a succession of tonic chronic seizure without return of consciousness? This is a medical emergency as life is threatened also brain damage seizure it occur in patient with grand ma or partial epilepsies and frequently follow some specific organic stress such as with drawl of anti convulsive medicine, heavy intake of alcohol abrupt cassation of drinking in an individual inabituated to alcohol or high temperature accompanying infection.

1.7    GENERAL CONTROL AND PREVENTION OF MENTAL ILLNESS.

1.     Knowledge on evidence for effectiveness need further expansion: -  further efforts are need to expand the spectrum of effective preventive intervention, to improve their effectiveness in varied setting and to strengthen the evidence base.
2.     Population based outcomes required human and vestments:- population based outcomes can only be expected when sufficient human and financial resources are invested.
3.     Prevention needs to be sensitive to cultural any to resources available across countries: - current opportunities for prevention of mental disorder and mental health promotion are unevenly distributed around the world.
4.     Effective prevention requires intersectional lineages: - prevention of mental disorders and mental health promotion need to be integral part of public health and health promotion policies at local and national levels.
5.     Protecting human rights is a major strategy to prevent mental disorders:- adverse conditions such as abuse, violence, war, discrimination, poverty and lack of access of education have a significant impact on the development of mental ill-health and the onset of mental disorders.
CHAPTER THREE
3.0            RESEARCH METHODOLOGY
3.1            STUDY DESIGN
This study is a descriptive research work carried out in Oka-Akoko Southwest Local Government in Ondo State, it is based on the socio-culture causes and management of psychosis among youth in the above named community.
3.2            STUDY SETTING
Oka-akoko southwest local government are of Ondo State usew as the focus of the study is one of recongnised local government according to the last 1991 census result but it that the population figure the local government has about 495,735 people (four hundred and ninety five thousand seven hundred and thirty five) thereby putting it as most populated local government area in the state. The town of oka-akoko was located at 75 kilometer southwest of ondo state (Akure) the present capital of Ondo state. Rainfall in the area last for a period of three to six months, this explain how the main crops annually produced.

3.3            SAMPLING TECHNIQUE
Sampling technique is used to select fifty(50) respondents for the study. The simple random sampling technique gives every member of the community equal chance of being selected. It used to collect relevant information needed for this research work.

3.4            INSTRUMENT DESIGN
The instrument design made use in this project work in two parts. The research made use of questionnaires and interview to collect relevant information.

3.4.1    QUESTIONAIRES
The questionnaires will be used by the research with the aids and guidance of the supervision of this project. The questionnaires will be in two parts dichotomous and open ended.

3.4.2    INTERVIEW
In order to collect the necessary information and arrive at a conclusion about the socio-cultural cause, management of psychosis among the youth in oka-akoko Ondo state interview as an instrument for collecting data was also used. The researcher finds time to interview the health workers in the community.

3.5            METHOD OF DATA COLLECTION
The techniques used in data collection in this research work basically questionnaires, which is faithfully designed and administered randomly some of the respondent are literate while some are illiterates the literate people were able to answer the question themselves while the question were interpreted to the illiterate orally. The answers given were ticked appropriately by the researcher.

3.6            METHOD OF DATA ANALYSIS
The data collected were processed and analyzed in tabular form while simple percentage was used in presenting the data for better understanding.

3.7            LIMITATION OF STUDY
There were some constraints encountered in carrying out the research of study, transportation problems arouse due to the nature of the community.
Financially, constrain during the project writing serve as barrier to the research procedures. The respondent felt reluctant in answering the question for the fear that the information would use to asses them.

CHAPTER FOUR
4.0                 DATA ANALYSIS AND PRESENTATION
       A questinaire on socio-cultural cause and management of psychosis among the youth was conducted in Oka-Akoko metropolis.
      The questionnaire was administer on fifty (50) respondent and the whole copies were return to researcher with satisfactory response by the community members

TABLE 4:1 SHOW THE SEX DISTRIBUTION RESPONDENT
SEX RESPONDENT
    FIGURE
PERCENTAGE
FEMALE
         20
      40%
MALE
         30
      60%
TOTAL
         50
     100%

The table shows those female respondents are 20 (40%) while male respondent are 30 (60%). The male respondents are the majority

TABLE 4:2 SHOWS THE AGE DISTRIBUTION OF THE RESPONDENT
AGE RESPONDENT
FIGURE
PERCENTAGE
15-20
      15
     30%
21-25
      25
     50%
26 and above
      10
     20%
TOTAL
      50
     100%
The above table  indicate that age 15-20 respondents are 15(30%) 21-25 respondents are 25(50%)  while 26 and above respondent are 10(20).the age 21-25 respondents form the majority.





TABLE 4:3 SHOWS THE MARITAL STATUS OF THE RESPONDENTS
MARITAL STATUS RESPONDENT
FIGURE
PERCENTAGE
SINGLE
    19
    38%
MARRIED
    20
    40%
DIVORCE
    11
    22%
TOTAL
    50
    100%

The above table shows that respondents 19 (30%) are single while married respondent are 20 (40%) and divorce respondent 11(22%)

 TABLE 4:4 SHOWS THE EDUCATIONAL BACKGROUND OF RESPONDENT
EDUCATIONAL BACKGROUND
FIGURE
PERCENTAGE
PRIMARY
      10
     20%
SECONARY
      14
     28%
TERTIARY
      26
     52%
TOTAL
      50
     100%

The table shows that 10(20%) respondents have primary option 14(20%) respondent have secondary education representing 26(52%) respondent obtained their tertiary education. It is confirmed that respondent with tertiary education forms the majority.

 TABLE 4:5 SHOWS THE RELIGION DISTRIBUTION OF THE RESPONDENTS
RELIGION RESPONDENT
FIGURE
PERCENTAGE
CHRISTIANITY
       21
     42%
TRADITIONAL
       14
     28%
ISLAM
       15
      30%
TOTAL
        50
    100%


The above table shows that 21 (42%) respondent practices christanity,1 5 (30%) were Islam while respondent chart practice traditional religion are (20%)

TABLE 4:6 SHOWS THE OCCUPATIONAL DISTRIBUTION OF THE RESPONDENTS
OCCUPATIONAL  RESPONDENTS
FIGURE
PERCENTAGE
CIVIL SERVANT
  15
   30%
STUDENT
  22
     44%
TEACHER
  13
     26%
TOTAL
  50
     100%

The table above indications that is 15(30%) respondents are civil servant, student respondents is 22(44%) while 13(26%) respondents are teacher. It is concluded that students from the majority.

TABLE 4:7 SHOWS THE RESPONDENTS AWARENESS OF PSYCHOSIS
RESPONDENTS  AWARENESS
FIGURE
PERCENTAGE
YES
38
    76%
NO
12
     24%
TOTAL
50
     100%

The table shows that 38(76%) respondents are awareness while 12 (24%) respondents are not awareness form a majority

TABLE 4:8 SHOWS RESPONDENTS BELIEVE WHETHER PSYCHOSIS IS CONTAGIOUS
RESPONDENT BELIEVE
FIGURE
PERCENTAGE
YES
       22
        44%
NO
       28
        56%
TOTAL
       50
        100%

The table above indicate that 22(44%) respondent believe that psychosis is contagious while 28(56%) respondent did not believe, it is confirmed that respondent who believe is not contagious forms the majority

TABLE 4:9 SHOWS THE RESPONDENTS BELIEVE ON CAUSE OF PSYCHOSIS
RESPONDENT BELIEVE CAUSE
FIGURE
PERCENTAGE
EVIL SPIRIT
      9
      18%
DRUG ADDICTION
      20
      40%
ACT OF GOD
      21
      42%
TOTAL
      50
      100%

The table shows that 9(18%) are evil spirit were 20(40%0 are drug addiction and 21(425) are act of God

TABLE 4:10 SHOWS THE RESPONDENT BELIEVE THAT MENTAL ILLNESS CAN BE CURED
RESPONDENT BELIEVE
FIGURE
PERCENTAGE
YES
         37
       74%
NO
          13
       26%
TOTAL
          50
      100%

The table shows that 37(74%) respondents did not believe that psychosis can be cured, those believe forms the majority

TABLE 4:11 SHOWS THE RESPONDENTS OPINION ON WHETHER PSYCHOSIS CAN BE INHERITED
RESPONDENT BELIEVE
FIGURE
PERCENTAGE
YES
              20
          40%
NO
             30
          60%
TOTAL
50
          100%

The table above shows that 20(40%) respondents believe that it is inherited while 30(60%) respondents believe forms the majority.

 TABLE 4:12 SHOWS THE RESPONDENTS IMPRESSION ON WHETHER HEAD INJURY RESULTING FROM ACCIDENT CAN PREDISPOSE
RESPONDENT BELIEVE
FIGURE
PERCENTAGE
YES
       43
    86%
NO
         7
     14% 
TOTAL
        50
      100%

The table above indicates that 43(86%) respondents believe while 9(14%) respondents did not believe that head injury from accident predispose psychosis form the majority

TABLE 4:13 SHOWS THE RESPONDENTS BELIEVE THE BEATEN OF MENTAL ILL PAYIENT CQAN SOLVE THEIR PROBLEM
RESPONDENT BELIEVE
FIGURE
PERCENTAGE
YES
       31
             68%
NO
      19
             38%
TOTAL
      50
           100%

The table shows that 31(62%) respondent believe while 19(38%) respondents did not believe that beaten of a mental ill patient can solve their problem and it form the majority


TABLE 4:14 SHOWS THE RESPONDENTS OF THE BELIEVE THAT MENTALLY SICK PATIENT ENTERS MARKET CA NOT BE CURED AGAIN
RESPONDENT  BELIEVE
FIGURE
PERCENTAGE
YES
         29
            58%
NO
          21
            42%
TOTAL
         50
            100%

The table shows that 29(58%) respondent believe we conclude that those whole believe forms the majority

TABLE 4:15 SHOWS THE FAMILY OF RELATIVE OF FRIEND THAT MENTALLY ILL
RESPONDENT BELIEVE
 FIGURE
PERCENTAGE
YES
        17
          34%
NO
        33
         66%
TOTAL
         50
        100%

The table shows that 17(34%) respondent believe while 33(66%) did not believe

     TABLE 4:16 SHOW THE PLACE OF TREATMENT FOR MENTAL ILLNESS (PSYCHOSIS)
PLACE OF TREATMENT RESPONDENT
FIGURE
PERCENTAGE
CHURCH
      10
    20%
MOSQUE
        7
     18%
HERBALIST
       3
       6%    
HOSPITAL
      28
       56%
TOTAL
      50
       100%



The table shows that 10(20%) respondents go to church 19(18%) respondents go to mosque while those respondent go to herbalist 3(6%) and 28(56%) respondents go to hospital

TABLE 4:17 SHOWS THE RESONDENT BELIEVE THAT MENTAL ILLNESS IS INCURABLE
RESPONDENT BELIEVE
FIGURE
PERCENTAGE
YES
       41
        82%
NO
         9
        18%
TOTAL
        50
        100%

The table show that 41(82%) respondent and while 9(18%) respondent believe that mental illness is incurable

  TABLE 4:18 SHOWS THE RESPONDENT OF THE BELIEVE THAT MENTAL ILLNESS IS INFECTION

RESPONDENT BELIEVE
FIGURE
PERCENTAGE
YES
        27
     54%
NO
        23 
     46%
TOTAL
       50
     100%

The above table shows that 27(54%) respondent believe that it is infection and while 23(46%) respondent did not believe we conclude that those who believe form the majority

TABLE 4:19 SHOWS THE RESPONDENTS BELIEVE THAT MENTAL ILLNESS IS TRANSMIT FROM ONE PERSON TO ANOTHER PERSON

RESPONDENTBELIEVE
 FIGURE
PERCENTAGE
YES
       30
      60%
NO
        20
       40%
TOTAL
        50
     100%

The above table indicates that 15(30%) respondent believe while 35(70%) respondent did not believe we conclude that those who believe form are majority

TABLE 4:20 SHOWS THE RESPONDENTS BELIEVE THAT MENTAL ILLNESS IS A CHRONIC CONDITION
RESPONDENT BELIEVE
FIGURE
PERCENTAGE
YES
         30
              60%
NO
         20
             40%
TOTAL
        50
             100%

The table shows that 30(60%) respondents believe and while 20(40%) respondents did not believe that mental illness is a chronic condition.


CHAPTER FIVE
5.0            SUMMARY
The study of the socio-cultural causes and management of psychosis among the youth in Oka-Akoko metropolis are known to influence both positively and negatively. To achieve set out health goal positively. The effect of socio cultural on the cause of psychosis among the youth cannot be cover emphasized in Oka-Akoko metropolis the positive and negative effect of health standard of the people using Oka-Akoko metropolis in Ondo state as a reference point
      The rate of mental illness is the arrested or incomplete development of mind, psychopathic disorder may other disorder or disability of mind, which is as a result of negative effect of socio cultural practice in that area. Socio aspect of it like hereditary psychogenic and trauma cause mental illness on human health.
The effect is rampaged among the youth owing to some factor from per group and some other factors, like environmental factor, biochemical factors e.t.c.


5.1 CONCLUSION
    Based on the responses from the questionnaire, interview, conducted and the observation by the researcher, one could simply deduce that psychosis is caused by socialization due to taking of narcotic drugs, drug abuse and other causes such as infection, malnutrition in pregnancy which may interfere with fetus, accidents injur4y, and it’s because they lack health education. The researcher tried to enlighten the community on proper upbringing of their children and good antenatal care during pregnancy  


5.2             RECOMMENDATION
The following recommendation is made to the state, local government and the community under study area /Oka-Akoko metropolis in order to reduce or eradicate the occurrence among the youth in the community.
1.     The state government in conjunction with  local government and the community should organize a senior  symposium for the youth and the community to enlightened them on the causes economical and socio effects  on  the community
2.     Marriage counseling :-the family should advice the couple before marriage so that they will rule out some hereditary mental illness in the family before marriage
3.     Health education on ante-natal visit mother should be advice on the importance of antenatal care which will help top prevent mental problem in early life.
4.     Child abuse campaign: - the local government with community should involve in a programmed against child abuse to reduce the problem facing the children.
5.     Immunization: - Mass immunization on some infection disease which can later have effect or affect the brain tissue causing mental disorder should avoid.
6.     Government should enact law on the issuing and sales of narcotic drugs which many causing problem to the youth and the community as a whole.
7.     The individual should avoid any form of frustration and stress which may cause mental illness.

REFERENCE
Adeleke A.A  (1993) Hand book on psychiatry for Nursing Ilorin
British mental health Act 1959 Great Britain
curran d.etal (1972) an introduction to psychiatry printed in Great Britain
Gidson J.L (1977) integrated clinical science printed in Ibadan
Lecture note by Mr. Adeniyi or Neuro psychiatric Hospital Aro (199001991)
Michael D, S (1969) plan as a clinically significant behavioral or psychological syndrome printed in Ogun State

Comrade Mustapha Abdullahi Akanbi Handout on community mental health printed in Ilorin
Asumi .T.etal (1994) mental health and disease in African printed in Ilorin
Jaiye oba D.A      (1980) psychiatry and psychiatry Nursing practice OgunState


APPENDIX
QUESTIONNAIRE

DEPARTMENT OF ENVIRONMENTAL HEALTH TECHNOLOGY OFFA,
P.M.B 430
OFFA, KWARA STATE

QUESTIONNAIRE ON AN INVESTIGATION ON THE SOCIO-CULTURAL CAUSES AND MANAGEMENT OF PSYCHOSIS AMONG YOUTH IN OKA-AKOKO METROPOLIS
         I ..................... student of  Kwara State College of Health Technology Offa, Environment Department.

Sir/Ma
       This questionnaire is designed to know the level of awareness of the people toward the socio-cultural causes and management of psychosis among the youth in Oka-akoko metropolis.
      Kindly read through the questionnaire and respond to the questions positively, faithfully and honestly as possible.  The response will be treated with great confidentially


                                                                                  Yours faithfully
               
                                                                                                                                                                                                                        


SECTION A
Instruction tick (   ) the appropriate and correct option from the options provided below
1.     SEX: - A. Male {   } B. Female {   }
2.     AGE: - A. 15-20 {   } B. 21-25 {   } C. 26 and above {   }
3.     RELIGION: - A. Christianity {   } B. Islam {   } C. Tradition {   }
4.     MARITAL STATUS: A. Single {   } B. Married C. Divorced {   }
5.     EDUCATION:-  A. Primary {   } B. Secondary {   } C. Tertiary {   }
6.     OCCUPATION: - A. student {   } B. Civil servant  {   } C. Teacher {   }
SECTION B
7.     Have you heard about psychosis before? A. Yes {   } B. No {   }
8.     Is it contagious (psychosis)? A. Yes {   } B. No {   }
9.     What is your believe about the causes of psychosis? A. Yes {   }
B. No {   }
10.                        Can mental illness be cured? A. Yes {   } B. No {   }
11.                        Can we inherit mental illness? A. Yes {   } B. No {   }
12.                        Do you believe that head injury from accident can cause mental illness? A. Yes {   } B. No {   }
13.                        Do you believe that beaten a mentally ill patient can solve their problem? A. Yes {   } B. No {   }
14.                        Do you believe that mentally sick patient that entering to market can get cured? A. Yes {   } B. No {   }
15.                        Do you have family or relative of friend that has mental illness?
 A. Yes {   } B. No {   }
16.                        If yes where is the place of treatment? A. Hospital {   }B. Mosque {   }   C. Herbalist {   }
17.                        Do you believe that illness is incurable? A. Yes {   } B. No {   }
18.                        Do you believe that illness is infection? A. Yes {   } B. No {   }
19.                        Do you believe that mental illness is transmitting from one person to another person?  A. Yes {   } B. No {   }
20.                        Do you believe that mental illness is a chronic condition? A. Yes {   } B. No {   }



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