Bipolar disorders in Nigeria: a mixed-methods study of patients, family caregivers, clinicians, and the community members’ perspectives

Background: Bipolar Disorders (BDs) are chronic mental health disorders that often result in functional impairment and contribute significantly to the disability-adjusted life years (DALY). BDs are historically under-researched compared to other mental health disorders, especially in Sub-Saharan Africa and Nigeria. Design: A mixed-methods design was utilised, with Study 1 exploring knowledge of mood management in BDs in relation to sociodemographic outcomes using quantitative data. Study 2 qualitatively assesses the lived experiences of patients with BDs, clinicians, and family members. Methods: In Study 1, a non-clinical sample of n = 575 participants responded to a compact questionnaire that assessed their knowledge and beliefs about BDs and how they relate to certain sociodemographic variables. One-way ANOVA was used to analyse quantitative data. Study 2 interviewed N = 15 (n = 5 patients with BDs; n = 7 clinicians; n = 3 family caregivers). These semi-structured interviews were audio-recorded, transcribed, and thematically analysed. Results: In Study 1, findings showed no statistically significant differences, suggesting low awareness of BDs, especially among vulnerable populations such as young people and older adults. However, there was a trajectory in increased knowledge of BDs among participants between the ages of 25-44 years and part-time workers compared to other ages and employment status. In Study 2, qualitative findings showed that BDs are perceived to be genetically and psycho-socially induced by specific lived experiences of patients and their caregivers or family members. Although psychotropic medications and psychotherapy are available treatment options in Nigeria, cultural and religious beliefs were significant barriers to treatment uptake. Conclusions: This study provides insight into knowledge and beliefs about BDs in Nigeria. The present study provides evidence of the lived experiences of patients with BDs, their caregivers and clinicians in Nigeria. It highlights the need for further studies assessing Nigeria's feasibility and acceptability of culturally adapted psychosocial interventions for patients with BDs